Flashcards in 11.20: Pulm III Deck (51)
Appearance of silicosis?
- Nodules of "Whorled" hyalinized collagen
- Nodules can coalesce leading to massive fibrosis extending to hilar lymph nodes and pleura
"Eggshell calcification" of lymph nodes
When is egg shell calcification of lymph nodes seen?
What does silicosis lead to increased susceptibility to?
- Silicosis suppresses cell mediated immunity and impairs macrophage phagocytosis
What can silicosis lead to?
2. Pulm htn
3. Cor pulmonale
Disease often associated with silicosis?
Disease often associated with coal workers?
Which form of Pneumoconioses is carcinogenic?
Why is asbestos often used?
3. Head resistant for insulation
Which type of asbestos is most dangerous?
- Rigid, rod like molecule that can poke hole through macrophage
What does asbestos lead to?
1. Interstitial Fibrosis
2. Localized fibrotic pleural plaques
3. Malignant mesothelioma
4. Bronchogenic carcinoma
5. Laryngeal Carcinoma
6. Pleural effusion
What cause malignant mesothelioma?
Hallmark of asbestos?
- Fibrinous "Asbestos bodies"
- Looks like beaded structure with nobby head
- Fe will sit on and coat the asbestos body
How much does asbestos increase cancer risk?
- 55x if a smoker
- 5 x if not a smoker
- 1000x increased risk in mesothelioma
***Family members are at risk through indirect exposure
***Can occur 20 - 40 years after exposure
Characteristics of Sarcoidosis?
- Multisystem disease of unknown etiology
- Characterized by non caseating granulomas
- Diagnosis of exclusion in which TB or fungus must be ruled out when granulomas are seen
What is a granuloma?
- Lymphocytes, macrophages that have fused to form giant cells
Clincial presentation of sarcoidosis?
- 90% with bilateral hilar lymphadenopathy or parenchymal abnormality on chest xray
What leads to sarcoidosis?
- Genetic abnormality with environmental trigger
When are asteroid and schaumann bodies seen?
Manifestations of sarcoidosis?
- SOB with dry cough
- Fever fatigue sweats
- Eye in inflammation: Uveitis
- Erythema nodosum
- Restrictive cardiomyopathy
What is erythema nodosum?
Inflammatory lesions of subcutaneous fat see in skin in sarcoidosis