What is Interstitial lung disease is seen in - and explain in detail?
Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.495 ILD ASSOCIATED WITH CONNECTIVE TISSUE DISEASES A number of connective tissue diseases or collagen diseases may result in chronic interstitial fibrosis and destruction of blood vessels. The lung involvement in impoant forms of collagen diseases is briefly considered here. 1. SCLERODERMA (PROGRESSIVE SYSTEMIC SCLEROSIS). The lungs are involved in 80% cases of scleroderma. Interstitial pulmonary fibrosis is the most common form of pulmonary involvement. The disease usually involves the lower lobes and subpleural regions of the lungs and may lead to honeycombing of the lung. There is increased risk of development of cancer of the lung in pulmonary fibrosis in scleroderma. 2. RHEUMATOID AHRITIS. Pulmonary involvement in rheumatoid ahritis may result in pleural effusion, interstitial pneumonitis, necrobiotic nodules and rheumatoid pneumoconiosis (Caplan's syndrome). The parenchymatous lesions in rheumatoid ahritis are most commonly seen in the lower lobe. Necrobiotic nodules are the most specific manifestations of rheumatoid disease and closely resemble the subcutaneous nodules commonly found in rheumatoid ahritis. 3. SYSTEMIC LUPUS ERYTHEMATOSUS Patients with systemic lupus erythematosus (SLE) commonly develop some form of lung disease during the course. The most common manifestation of SLE is pleurisy with small amount of pleural effusion that may contain LE cells. Other pulmonary lesions in SLE are interstitial pneumonitis, pulmonary haemorrhage and vasculitis. 4. SJOGREN'S SYNDROME Patients with Sjogren's syndrome often have rheumatoid ahritis and associated pulmonary changes. Involvement of the bronchial mucous gland by a process similar to that in the salivary glands can lead to inadequate bronchial clearance and repeated infections. 5. DERMATOMYOSITIS AND POLYMYOSITIS. Interstitial pneumonitis and interstitial fibrosis commonly accompany dermatomyositis and polymyositis. 6. WEGENER'S GRANULOMATOSIS. Wegener's granulomatosis is an necro-inflammatory lesion having 4 components--granulomas of the upper respiratory tract, granulomas of the lungs, systemic vasculitis and focal necrotising glomerulonephritis. Localised or limited form of the disease occurs in the lungs without involvement of other organs. Pulmonary involvement is in the form of single or multiple granulomas.