🐭 RAT series
Points to Ponder for NEET-PG, FMGE & NEXT
- Asbestos bodies in Diffuse pulmonary interstitial fibrosis are a hallmark finding of asbestosis.
- The fibrosis pattern in asbestosis resembles usual interstitial pneumonia (UIP) but has a lower lobe predominance.
- Pleural plaques are a common manifestation of asbestos exposure but are not indicative of significant lung dysfunction.
- Asbestos exposure is a risk factor for both lung carcinoma and mesothelioma.
- Cigarette smoking significantly increases the risk of lung carcinoma but not mesothelioma.
Fibrosis pattern:
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- Diffuse pulmonary interstitial fibrosis similar pattern to usual interstitial pneumonia (UIP)
- Starts around respiratory bronchioles and alveolar ducts
- Extends to involve adjacent alveolar sacs and alveoli
- Distorts lung architecture, creating Honeycombing in affected regions:
- Thickened fibrous walls encloses the enlarged airspaces
- Distribution: Begins in the lower lobes and subpleurally (progresses even after the exposure is stopped)
Asbestos bodies:
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- Appearance: Golden brown, fusiform (spindle-shaped) or beaded rods with a translucent center
- Composition: Asbestos fibers coated with iron-containing proteinaceous material
- Origin: Macrophages attempt to phagocytose asbestos fibers
- Iron source: Presumably derived from phagocyte ferritin
- Note: Other inorganic particulates with similar iron-protein complexes are called ferruginous bodies.
Pleural Plaques:
- Most common manifestation of asbestos exposure
- Well-circumscribed plaques of dense collagen, often containing calcium
- Develop most frequently on:
- Anterior pleura
- Posterolateral aspects of the parietal pleura
- Domes of the diaphragm
Malignancies:
- Asbestos exposure is linked to:
- Lung carcinomas
- Mesotheliomas (pleural and peritoneal)
- Concomitant cigarette smoking:
- Greatly increases risk of lung carcinoma
- Does not significantly affect mesothelioma risk
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