Diffuse smoking-related lung diseases: insights from a radiologic-pathologic correlation

Abstract

Cigarettes are well-recognized risk factors responsible for the emergence of a variety of pathologic conditions affecting both the airways and the lungs. Smoking-related lung diseases can be classified as chronic obstructive pulmonary disease (COPD) and several types of interstitial diseases, such as pulmonary Langerhans cell histiocytosis, bronchiolitis, desquamative interstitial pneumonitis, acute eosinophilic pneumonia, and interstitial fibrosing lung diseases. The evidence of combined lower lung fibrosis and predominant upper lung emphysema is renowned as a distinct clinical entity, named combined pulmonary fibrosis and emphysema. Although computerized tomography permits an adequate classification and distinction of these diseases, the clinical, imaging, and histological features often overlap and coexist in a single patient. Therefore, a combined radiologic and pathologic approach, in the appropriate clinical setting, is useful for best comprehension and distinction of these entities. Our goals are to describe the imaging features in smoking-related lung diseases and how the pathological manifestations translate on high-resolution computerized tomography.

Considering Xenobiotics as Risk Factors for Postpartum Depression: A Qualitative Systematic Review

“…The studies that focused on cigarette/tobacco smoke exposure studies reported that exposure to this toxicant during the prenatal and/or perinatal period was primarily found to increase the risk of developing postpartum depression and depressive symptoms in the postpartum period. It is already well known that active smoking can have harmful effects on one's health by increasing the risk of lung cancer and respiratory conditions ( Hawari et al, 2019;Laniado-Laborín, 2009;Papadopoulos et al, 2011;Sousa et al, 2019), however, the studies in this review demonstrated that not only does tobacco exposure affect physical health but can most notably affect mental health. The prenatal and perinatal periods are sensitive times for women as they are undergoing physiological changes (Soma-Pillay et al, 2016;Talbot & Maclennan, 2016) and experiencing drastic lifestyle changes (relating to sleep, diet, exercise, etc.)…”

An Elderly Smoker Presenting With Pulmonary Langerhans Cell Histiocytosis: An Unusual Demographic

“…Smoking cigarettes is a known risk factor for multiple pulmonary conditions, including COPD, emphysema, bronchitis, interstitial fibrosing lung disease, bronchiolitis, acute eosinophilic pneumonia, and Langerhans cell histiocytosis [ 2 ]. Initially, our patient had presented with mild dyspnea for a routine lung cancer screening CT scan, was found to have new lung nodules on chest imaging, and underwent further work-up further due to concerns for malignancy in view of her smoking history.…”

“…PLCH is a rare neoplastic condition that occurs almost exclusively in smokers, is commonest in a younger demographic (20-40 years of age), has no gender preference, and presents with multiple solid and/or cystic nodules in a primarily upper lobe distribution on chest imaging (Figures 1 , 2 ) [ 2 , 3 ]. Definitive diagnosis requires biopsy and histopathological identification of eosinophilic granulomas with Langerhans cells present (CD1a, CD207, or S-100 positive), as with our patient (Figure 4 ) [ 2 - 5 ].…”

“…As many as 25% of patients can also present with incidental findings on chest imaging performed for either lung cancer screening or an alternate reason. Pneumothorax is an additional common entity that occurs in up to 45% of PLCH patients throughout the course of their disease and may be a presenting feature in 15%-20% of patients [ 2 , 3 ].…”

“…This case exhibits the stereotypical findings of PLCH on imaging and biopsy studies. This particular patient is unique in that she falls well beyond the typical age demographic of 20-40 years [ 2 ], where this condition is most often expected, reinforcing the fact that we should consider atypical presentations in our differential diagnosis of lung nodules.…”