Flashcards in Lung Deck (452)
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60
Follicular bronchiolitis: Associations.
Anything that causes lymphoid hyperplasia, e.g. chronic inflammation, infections.
61
Diffuse alveolar damage: Clinical equivalents (3).
Acute respiratory-distress syndrome.
Acute interstitial pneumonia.
Acute lung injury.
62
Diffuse alveolar damage: Relevance to autoimmune disease (2).
Various collagen-vascular diseases cause DAD-type inflammation.
Various vasculitides can resemble AIP clinically.
63
Diffuse alveolar damage: Distribution of lesions (2).
Patchy involvement of the lung, but concentrated in the lower lobes.
Diffuse involvement of the alveolus.
64
Diffuse alveolar damage: Radiography.
Ground-glass opacities that spare the lobules.
65
Diffuse alveolar damage: Phases.
Exudative: First week.
Proliferative: Second week.
Fibrotic: Late.
66
Diffuse alveolar damage, exudative phase: Histology.
Hyaline membranes and interstitial edema.
67
Diffuse alveolar damage, proliferative phase: Histology.
Interstitium and airspaces: Florid proliferation of fibroblasts, myofibroblasts, type 2 pneumocytes.
Arteries: Intimal proliferation, medial hypertrophy.
68
Diffuse alveolar damage, fibrotic phase: Histology.
Dense interstitial fibrosis with microcysts.
69
Diffuse alveolar damage vs. usual interstitial pneumonia (3).
UIP:
− No hyaline membranes.
− Temporal heterogeneity of fibrosis.
− Fibrosis has more collagen and fewer cells.
70
Acute respiratory-distress syndrome: Prognosis.
Most patients regain near-normal lung function.
71
Acute interstitial pneumonia:
A. Clinical presentation.
B. Prognosis.
A. Resembles severe community-acquired pneumonia but does not respond to antibiotics.
B. Death in 6 months in 78% of cases.
72
Cryptogenic organizing pneumonia:
A. Clinical presentation.
B. Duration.
A. Cough, dyspnea, and flulike symptoms.
B. Subacute.
73
Cryptogenic organizing pneumonia: Prognosis.
Usually responds to steroids.
74
Cryptogenic organizing pneumonia: Distribution of lesions.
Subpleural.
75
Cryptogenic organizing pneumonia: Radiography.
Peribronchial consolidation and nodularity.
76
Cryptogenic organizing pneumonia: Histology (2).
Masson bodies: Intraluminal plugs consisting of young fibrous tissue.
Interstitial mild chronic inflammation with foci of foamy macrophages.
77
Cryptogenic organizing pneumonia: Special stain.
Movat's stain: Masson bodies appear green; dense fibrosis would appear yellow.
78
Cryptogenic organizing pneumonia vs. usual interstitial pneumonia.
UIP:
− Dense fibrosis (not seen in COP).
− Fibroblastic foci are interstitial, not intraluminal.
− Temporal heterogeneity of fibrosis.
79
Cryptogenic organizing pneumonia vs. nonspecific interstitial pneumonia.
NSIP: Interstitial chronic inflammation without Masson bodies.
80
Usual interstitial pneumonia:
A. Clinical presentation.
B. Duration.
A. Progressive dyspnea and cough.
B. Chronic.
81
Usual interstitial pneumonia:
A. Associated environmental agents (3).
B. Associated inherited diseases (2).
A. Cigarettes, asbestos, drugs.
B. Familial idiopathic pulmonary fibrosis, Hermansky-Pudlak syndrome.
82
Usual interstitial pneumonia: Association that imparts a better prognosis.
Collagen-vascular disease.
83
Usual interstitial pneumonia: Prognosis.
Median survival is 3 years.
84
Usual interstitial pneumonia: Distribution of lesions (2).
Subpleural.
Lower lobes.
85
Usual interstitial pneumonia: Radiography (3).
Honeycombing.
Ground-glass opacities.
Traction bronchiectasis.
86
Usual interstitial pneumonia: Histology.
Temporal heterogeneity: The same area may contain both mature fibrosis and subepithelial young fibrosis (fibroblastic foci).
Spatial heterogeneity: Some areas are affected, some not.
87
Usual interstitial pneumonia: Histologic findings associated with poor prognosis (4).
Diffuse alveolar damage.
Infection.
Capillaritis.
Organizing pneumonia.
88
Usual interstitial pneumonia vs. hypersensitivity pneumonitis with fibrosis.
Hypersensitivity pneumonitis:
− Mainly upper lobes.
− Centered on bronchioles.
− More cellular inflammation, including giant cells or poorly formed granulomas.
89
