engleski

Smoking-related interstitiallung disease

Smoking is a risk factor for the genesis of number of ILD. SR-ILD comprise of entities known to have a strong epidemiological association with smoking, like respiratory-bronchiolitis-associated interstitial lung disease(RB-ILD), desquamative interstitial pneumonia(DIP) and pulmonary Langerhans cell histiocytosis(PLCH). Smoking-related interstitial fibrosis(SRIF) is a distinct form of chronic interstitial fibrosis, denoted by thickening of alveolar septa by collagen deposition with minimal inflammation. It is important to separate SRIF which has a relatively benign course from both UIP and fibrosing NSIP. The histologic appearance of lung injury secondary to cigarette smoke is diverse and consist of smokers’ macrophages within airspaces, which may be airway centered(RB) or diffuse(DIP) in distribution, emphysema, small-airway injury with fibrosis, remodeling that results in distortion, thickening of walls of small arteries and arterioles, stellate cellular and fibrotic lesions of PLCH and alveolar wall fibrosis. SR-ILD are considered as distinct clinical entities but they share a number of clinical, radiological and pathological features, suggesting that they represent a spectrum of patterns of ILDs occurring in predisposed individuals who smoke. The patient suspected to suffer from SR-ILD should be referred to the pulmonologist. Early treatment with novel, even targeted therapies like in some LCH cases, and smoking cessation can improve clinical outcomes.

Smoking; interstitial lung disease

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