Inhalational lung disease

Pneumoconiosis

Inhalation of inorganic dust particles, some are benign while other are fibrogenic.

Silicosis - non caseating granulomas, predominantly upper lobe nodules and adenopathy, calcific nodules (20%), eggshell (5%)

Coal Workers Pneumoconiosis (CWP) - radiographically same as Silicosis

Asbestos - pleural plaques (some Ca), pleural effusions, interstitial fibrosis (asbestosis) is lower lobe predominany because macrophages can remove the fibers

Ag/Ab Mediated Lung Disease

Hypersensitivity Pneumonitis - granulomatous inflammation of bronchioles caused by immunologic response to inhaled organic material, diffuse ground glass, reticulonodular interstitial pattern, chronically can cause fibrosis, often upper lobe with honeycombing

Chronic Beryllium - T cell response to beryllium, similar to sarcoid

Pulmonary Infiltrates with Eosinophilla

• Loeffler's - idopathic, benign, transient, self limited
• Allergic Bronchopulmonary Aspergillosis (ABPA)
• Helminth
• Drugs

Goodpasture - binding of Ab to glomerular and alveolar membranes, hemoptysis and arf, pulmonary hemorrhage (consolidation with air bronchograms).

Silo Filler's - NO2 production in silos causes pulmonary edema and later BOOP