Thorax, Respiratory system, CT-High Resolution, Diagnostic procedure, Occupational / Environmental hazards
C. Sousa, A. Carvalho, M. S. C. Rodrigues, J. Rebelo, R. Cunha, S. Guimarães; Porto/PT
Tobacco smoke is a toxic and carcinogenic mixture containing an estimated 5.000 chemicals,
and is probably the most significant source of toxic chemical exposure and chemically mediated disease in humans.
The direct toxicity of cigarette smoke in the lung cells and the body’s inflammatory response to this injury induce both reversible and irreversible damage to the large airways,
and alveolar spaces.
Although all smokers have some degree of inflammation in the airways,
only a minority develop clinically significant diffuse lung disease.
Additional factors may be required for the induction of disease,
whether endogenous such as genetic factors or exogenous such as infectious pathogens or allergens.
Two of the most common tobacco smoke related causes of death are chronic obstructive pulmonary disease (COPD),
and various types of cancer,
in particular lung cancer.
In addition to these diseases,
cigarette smoking is also the most well-defined etiologic factor associated with the development of certain interstitial lung diseases (ILDs),
respiratory bronchiolitis-ILD (RB-ILD),
desquamative interstitial pneumonia (DIP),
pulmonary Langerhans cell histiocytosis (PLCH),
acute eosinophilic pneumonia (AEP),
and also a risk factor for the development of fibrosis.
Smoking-related lung damage represents a continuum of pathologic processes.
Pathologists often find a mixture of histopathological patterns in biopsy samples and a single pathologic diagnosis is often difficult to make.