Restrictive Lung Diseases

Question 1

Give 2 complications of RESTRICTIVE lung diseases

Answer 1

~ SECONDARY PULMONARY HPN —> Cor pulmonale
~ “HONEYCOMB LUNG”

Question 2

3 common interstitial lung diseases

Answer 2

~ FIBROSING diseases
~ GRANULOMATOUS disease
~ SMOKING-related diseases

Question 3

Histologic pattern of fibrosis: USUAL INTERSTITIAL PNEUMONIA (UIP)

Early lesion: (+) FIBSROBLASTIC FOCUS

Late lesion: (+) HONEYCOMB fibrosis

Answer 3

IDIOPATHIC PULMONARY FIBROSIS (IPF)

Question 4

Cellular pattern:CHRONIC INFLAMMATION

Fibrosing pattern: INTERSTITIAL FIBROSIS

It has BETTER PROGNOSIS than IPF

(+) FEMALE NONSMOKERS 60 Y/O

Answer 4

NONSPECIFIC INTERSTITIAL PNEUMONIA

Question 5

(+) MASSON BODIES

Answer 5

CRYPTOGENIC ORGANIZING PNEUMONIA

MASSON bodies — polypoid plugs of LOOSE ORGANIZING CONNECTIVE TISSUE within airways and alveoli

Question 6

Most common indication for LUNG TRANSPLANTATION

Answer 6

IPF/ IDIOPATHIC PULMONARY FIBROSIS

Followed by COPD

Question 7

NONNEOPLASTIC lung reaction to inhalation of MINERAL DUSTS encountered in the workplace

Answer 7

PNEUMOCONIOSIS

Common pathogenesis:
~ Particles phagocytized by pulmonary macrophages —> inflammation —> fibrosis

Question 8

Carbon-laden macrophages

Answer 8

Coal MACULES (1-2 mm) — seen in SIMPLE COAL WORKERS’ PNEUMOCONIOSIS (CWP)

Question 9

Carbon-laden MACROPHAGES + COLLAGEN fiber network

Answer 9

Coal NODULES
— seen in SIMPLE COAL WORKERS’ PNEUMOCONIOSIS (CWP)

Question 10

MOST PREVALENT CHRONIC OCCUPATIONAL DISEASE

Answer 10

SILICOSIS
— Increased susceptibility to TB
— Increased risk of lung CA

Question 11

CXR:
~ UPPER lobes
~ “EGGSHELL CALCIFICATIONS”: Lymph nodes

Morphology
~ (+) HARD COLLAGENOUS SCARS: central whorled collagen + rim of dust-laden macrophages

Answer 11

SILICOSIS

Question 12

More PATHIGENIC form which causes Asbestos-related. Diseases

Answer 12

AMPHIBOLE form

Question 13

Risk of BRONCHOGENIC CA > risk ofmesothelioma

CXR:
~ “IVORY WHITE” calcified supradiaphragmatic and pleural plaques
~ Recurrent pleural effusions

Answer 13

ASBESTOS-RELATED DISEASES

Question 14

These are golden-brown, rods with translucent center consisting of ASBESTOS fibers coated with an iron-containing proteinaceous material

Answer 14

ASBESTOS bodies

Question 15

These are other INORGANIC (Non-asbestos) particulates coated with similar IRON-protein complexes

Answer 15

FERRUGINOUS bodies

Question 16

(+) Calcified pleural plaques, shipbuilding, ROOF insulation, tiling

Answer 16

ASBESTOSIS

Question 17

(+) EGGSHELL calcification, stone blasting, sandblasting, quarrying

Answer 17

SILICOSIS

Question 18

(+) Nodules along SEPTAL line, high-tech industries

Answer 18

BERYLLOSIS

Question 19

(+) Hilar adenopathy, cotton

Answer 19

BYSSINOSIS

Question 20

Diagnostic histologic finding:
NON-caseating GRANULOMAS with GIANT cells that may contain SCHAUMANN bodies and ASTEROID bodies

Answer 20

SARCOIDOSIS

Question 21

What are the most common organs (2) involved in Sarcoidosis?

Answer 21

Lymph nodes and Lung

Question 22

These are LAMINATED concretions composed of CALCIUM and PROTEINS

Answer 22

SCHAUMANN bodies
— seen in SARCOIDOSIS

Question 23

These are STELLATE inclusions

Answer 23

ASTEROID bodies
— seen in SARCOIDOSIS

Question 24

DUSTY BROWN PIGMENT-laden macrophages and may contain SURFACTANT-derived bodies due to phagocytosis pf necrotic TYPE 2 PNEUMOCYTES

Answer 24

SMOKERS’ MACROPHAGES

Question 25

(+) smokers’ macrophages in ALVEOLAR spaces

Answer 25

DESQUAMATIVE INTERSTITIAL PNEUMONIA (DIP)

Question 26

(+) smokers’ macrophages in BRONCHIOLES, ALVEOLAR DUCTS

Answer 26

RESPIRATORY BRONCHIOLITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE