13.01.16

1

Topics for lecture test no 1 •  Pathology of upper respiratory tract and salivary glands •  Pathology of interstitial lung diseases •  Pathology of selected thymus diseases •  Pathology of DIC •  Pathology of non-neoplastic lymphadenopathy •  Pathology (morphologic changes) of anemias •  Pathology of congenital and acquired heart diseases •  Pathology of cardiomyopathies •  Pathology of heart tumors •  Pathology of vasculitis •  Pathology of vascular tumors •  Pathology of atherosclerosis •  Pathology (morphology) of infectious diseases •  Pathology of nutritional diseases •  Pathology of genetic diseases

•  Atypical pneumonias (morphology)

Lung fibrosis

The survival of patients treated for idiopathic pulmonary fibrosis: - In a group antedating the distinction of UIP and NSIP the median survival was about 4 years from the onset of symptoms → UIP pattern had a median survival nearer to 2 years

Idiopathic pulmonary fibrosis. • visceral pleura shows a ‘cobblestone’ pattern (reflecting changes in the underlying lung parenchyma) • pleura itself is not affected by the fibrotic process

• ‘honeycombing’.

Major Categories of Chronic Interstitial Lung Disease

•  FIBROSING –  Usual interstitial pneumonia (idiopathic pulmonary fibrosis) –  Nonspecific interstitial pneumonia –  Cryptogenic organizing pneumonia –  Associated with connective tissue diseases –  Pneumoconiosis –  Drug reactions –  Radiation pneumonitis

•  GRANULOMATOUS –  Sarcoidosis –  Hypersensitivity pneumonitis

•  EOSINOPHILIC •  SMOKING RELATED

–  Desquamative interstitial pneumonia –  Respiratory bronchiolitis-associated interstitial lung disease

•  OTHER –  Pulmonary alveolar proteinosis

13.01.16

2

Antigen stimulation

Activation of pulmonary immunocompetent cells

Release of cytokins

Alveolitis

Recovery

FIBROSIS

Production of granuloma Damage of lungs

pneumoconiosis

causes:

•  (anthracosis) •  (silicosis)

(most common; ↑TB) [lung ca.]

•  (azbestosis) [lung ca ↑5-55x, larynx, stomach, colon, mesothelioma ↑1000x]

•  (berylosis) [lung ca???]

•  (siderosis) •  (barytosis)

(fibrosis idiopathica pulmonum, idiopatic pulmonary fibrosis, IPF cryptogenic fibrosing alveolitis)

– 

(usual interstitial pneumonia, UIP)

–  (desquamative interstitial pneumonia, DIP) ← smoking-related

–  (acute interstitial pneumonia, AIP)

–  (non-specific interstitial pneumonia, NSIP)

13.01.16

3

Tobacco smoke •  Cancers of:

–  oral cavity, larynx,

–  lungs, –  urinary bladder, –  pancreas;

Smoking related diseases are such important cause of disability and premature death in developing countries, that the control of cigarette smoking could do more to improve health and prolong life in these countries than any other single action in the whole field of preventive medicine.