ILD Flashcards
(27 cards)
Pulmonary acinus (singuler)
Functional unit of lung where gas exchange takes place
ducts
sacs
alveoli
definition of lobule (important anatomic unit of lung)
lung parenchyma bounded by pleura and interlobular spetae (venules and lymphatics)
5-8 acini per lobule
in the center of a lobule the bronchioles are found associated with arterioles and lymphatics
where are they ?
artery
veins
arteries close to bronchioles, in center of lobule
veins are around lobules
The interstitial tissue of the lung provides a supporting framework for the airways, vessels and alveolar airspaces. It can be considered in two interconnecting “compartments”:
parenchyml and non parenchymal
parenchymal
in the alveolar wall and surrounding small vessels and lymphatics where gas exchange occurs
non parenchymal
in the pleura, interlobular septa and surrounding the large vessels and airways (center of lobule). No gas exchange
T or F : ILD patterns a disease specific
false
The patterns often overlap and are a mixed. The final diagnosis is a clinico-radiologic and pathological correlation
AIP
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
Acute interstitial pneomonitis
DAD
acute
everywhere
unknown
Diffuse alveolar damage
IPF
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
Idiopathic pulmonary fibrosis
UIP
Years to dev
Lower lobes
Unknown
Usual interstitial pneumonitis
Asbestosis
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
often UIP
Years to dev
lower lobes
exposure to asbestos fibers
CTD associated
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
CTD = connective tissue disease
NSIP, UIP, or OP
acute to chronic
anywhere, more often lower lobes
associated with CTD
Idiopathic NSIP
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
NSIP
subacute to chronic
lower lobe
unknown
Sarcoidosis
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
granulomatous
years to dev
typically upper lobes
unclear
Hypersensitivity pneumonitis
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
granulomatous
acute to chronic
typically upper lobes
exposure to antigens
COP
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
cryptogenic organizing pneumonitis
OP
Subacute
Patchy distribution
Unknown
Treatment related (medications, radiation therapy)
what is pathological pattern ?
time course?
zonal predominance ?
Etiology ?
mixed patterns
acute to chronic
anywhere
exposure to drugs, chemotherapy, radiation therapy
UIP pattern : 2 main features
- spatial heterogeneity
- Temporal heterogeneity
NSIP pattern : 2 main features
- Diffuse (spatial homo)
- uniform (temporal homo) inflammation and/or fibrosis
sarcoidosis characterized by
Non-necrotizing granulomas that follow bronchovascular bundles and lymphatics
UIP pattern histo
1. spatial hetero
2. temporal hetero
Patchy fibrosis that is found in the subpleural and paraseptal compartments
Unaffected (“spared”) areas (centrilobular)
End-stage remodeling: loss of lung architecture due to dense fibrosis, bronchiolar metaplasia and smooth muscle hyperplasia (microscopic “honeycombing”)
Early-stage remodeling: loose fibroblastic bodies in the interstium
Very little inflammation outside areas of honeycombing
No granulomas, no hyaline membranes
asbestosis CT scan
(comment différencier de IPF?)
calcified plaque on pleura
en plus du early honeycombing
OP pattern
histo
Active fibroblastic tissue (fibroblasts and loose connective tissue) inside the alveolar spaces
Usually bronchiolocentric
Inflammatory cells in interstitium
DAD pattern
histo
edema, epithelial necrosis, hyaline membranes in alveoli
NSIP pattern
- Diffuse (pan-lobular), uniform widening of interstitium with usually just focal intra-alveolar component
- Lung architecture is preserved
