11.03.2017 Views

DR Medhat MRCP

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Complicated CWP (progressive massive fibrosis)<br />

o The fibrous lesions reaches > 3 cm in diameter.<br />

o These large lesions undergo necrosis & cavitation.<br />

• Treatment : avoid coal dust exposure + supportive ttt.<br />

Normal CXR Complicated CWP Simple CWP<br />

NB : Caplan`s syndrome = Rheumatoid arthritis + CWP = well defined nodules in CXR<br />

Lung fibrosis<br />

- i.e diffuse fibrosis of lung parenchyma → ↓ gas transfer (DLCO) & V-P mismatching.<br />

أهم مافي الموضوع في االمتحان : Causes •<br />

Upper lung zone fibrosis<br />

1) TB<br />

2) Sarcoidosis<br />

3) Histiocytosis<br />

4) Pneumoconiosis except asbestosis<br />

Silicosis<br />

Coal worker pneumoconiosis<br />

5) Extrinsic allergic alveolitis.<br />

6) Allergic bronchopulmonary<br />

aspergillosis (ABPA)<br />

7) Ankylosing spondylitis<br />

Lower lung zone fibrosis<br />

1) Cryptogenic fibrosing alveolitis.<br />

2) CT disorders except (ankylosing<br />

spodylitis).<br />

3) Asbistosis<br />

4) Drug- induced lung fibrosis :<br />

أهم واحد - Cytotoxics : methotrexate<br />

Cyclophosphamide<br />

Bleomycin<br />

- Antibiotics : nitrofurantoin<br />

- CVS : amiodarone<br />

Hydralazine<br />

Tocanide<br />

- Opiates : Heroin<br />

- Salphasalazine.

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