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Published byTeresa Flowers Modified over 9 years ago
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by Shouvik Biswas #1451
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A term originally used to describe the non- neoplastic lung reaction to inhalation of mineral dusts. The term has been broadened to include organic as well as inorganic particulates, chemical fume, and vapor induced non- neoplastic lung diseases.
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Fibrotic - Involving focal nodular or diffuse fibrosis. - Types: Silicosis, coal worker’s pneumoconiosis (anthracosis), asbestosis, berylliosis, and talcosis. Non-fibrotic - Involving particle laden macrophages with minimal or no fibrosis. - Siderosis, stannosis, baritosis.
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Some of the particles become impacted at alveolar duct bifurcation, where macrophages accumulate and engulf the trapped particulates. The pulmonary alveolar macrophage is a key cellular element in the initiation and perpetuation of lung injury and fibrosis. Particles can activate the inflammasome (induce IL-1 production) or trigger the macrophages to release products that mediate an inflammatory response and initiate fibroblast proliferation and collagen deposition.
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Ingested silica particles cause activation and release of mediators by pulmonary macrophages, including IL-1, TNF, fibronectin, lipid mediators, oxygen-derived free radicals, and fibrogenic cytokines. Histopathology: - Concentrically arranged hyalinized mature collagen fibers. - Peripheral zone of particle laden macrophages. - Birefringent silicate crystals (1-3 um)
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Inhaled coal will form “coal macules” which are anthrocotic pigmentation without fibrotic tissue. Pigment laden macrophages surround the bronchioles in the lobular core. Primarily centrilobular distribution. Calcification develops a central nodular dot.
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Two distinct forms: - Serpentine: the fiber is curly and flexible with carcinogenic potential. - Amphibole: the fiber is straight and stiff; it has a greater fibrogenic potential. Asbestos bodies: golden brown, fusiform, or beaded rods with a translucent center. Pleural plaques are common manifestations of asbestos exposure.
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Parenchymal interstitial fibrosis Localized fibrous plaques or diffuse fibrosis in pleura Pleural effusion Lung carcinoma Malignant pleural and peritoneal manifestations Laryngeal carcinoma
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Chong, Semin, and Kyung Soo Lee. "Pneumoconiosis: Comparison of Imaging and Pathologic Findings." RadioGraphics:. 23 May 2005. Web. 11 Feb. 2015. http://pubs.rsna.org/doi/full/10.1148/rg.261055070 http://pubs.rsna.org/doi/full/10.1148/rg.261055070 Kumar, Vinay. "Lung." Robbins Basic Pathology. 9th ed. Philadelphia, PA: Elsevier/Saunders, 2013. 474-478. Print.
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