Learning objectives
To review and describe the clinical, pathological and radiological features of tobacco smoking-related interstitial lung diseases (SRILD).
Background
7.6 million Britons smoke (15.8% of adults) 1. Smoking remains the biggest preventable cause of death and disease in the United Kingdom and of the 80,000 deaths per year attributed to smoking approximately 50% are caused by respiratory disease 2. Smoking is responsible for over 80% of all deaths from lung cancer and chronic obstructive pulmonary disease 2.
The aim of this presentation is to highlight the clinical, pathological and radiological features of different smoking-related interstitial lung diseases (SRILDs).
Findings and procedure details
SRILDs encompasses a group of overlapping clinicopathologic entities that have a strong epidemiological association with smoking. An integrated clinical, pathological and radiological approach is recommended to diagnose specific entity 3-7.
Respiratory bronchiolitis (RB)
Clinical presentation:
Present in all current smokers.
Asymptomatic usually.
Histopathology:
Accumulation of pigmented macrophages in the respiratory bronchioles and adjacent alveoli.
Respiratory bronchiolitis interstitial lung disease (RB-ILD)
Clinical presentation:
Affecting current or former at 30-40 years old.
Mild cough and dyspnoea, or asymptomatic. Inspiratory crackles in 50%.
Pulmonary function tests (PFTs) may...
Conclusion
Tobacco smoking is associated with the development of several lung diseases, some of which may coexist. An integrated approach is important for optimal comprehension and distinction of smoking-related interstitial lung disease.
Personal information and conflict of interest
R. Riordan; Plymouth/UK - nothing to disclose C. Leung; Plymouth/UK - nothing to disclose S. H. M. Y. Y. Alqarooni; Plymouth/UK - nothing to disclose T. Purayil; Plymouth/UK - nothing to disclose
References
1. Office of National Statistics. Adult smoking habits in the UK: 2016.
2. Action on Smoking and Health. Available online (www.ash.org.uk).
3. Hidalgo A, Franquet T, Giménez A, et al. Smoking-related interstitial lung diseases: radiologic-pathologic correlation. Eur Radiol 2006;16:2463-2470.
4. Attili AK, Kazerooni EA, Gross BH, et al. Smoking-related interstitial lung disease: Radiologic-clinical-pathologic correlation. RadioGraphics 2008;28:1383-1398.
5. Hagmeyer L, Randerath W. Smoking-related interstitial lung disease. Dtsch Arztebl Int 2015;112:43-50.
6. Bak SH, Lee HY. Overlaps and uncertainties of smoking-related idiopathic interstitial pneumonias. International Journal of...