Book contents
- Frontmatter
- Dedication
- Contents
- Contents
- Contributors
- Foreword to the First Edition
- Preface to the Sixth Edition
- Acknowledgements
- Chapter 1 The normal lung: histology, embryology, development, aging and function
- Chapter 2 Lung specimen handling and practical considerations
- Chapter 3 Congenital abnormalities and pediatric lung diseases, including neoplasms
- Chapter 4 Pulmonary bacterial infections
- Chapter 5 Pulmonary viral infections
- Chapter 6 Pulmonary mycobacterial infections
- Chapter 7 Pulmonary mycotic infections
- Chapter 8 Pulmonary parasitic infections
- Chapter 9 Acute lung injury
- Chapter 10 Interstitial lung diseases
- Chapter 11 Metabolic and inherited connective tissue disorders involving the lung
- Chapter 12 Hypersensitivity pneumonitis
- Chapter 13 Sarcoidosis
- Chapter 14 Occupational lung disease
- Chapter 15 Eosinophilic lung disease
- Chapter 16 Drug- and therapy-induced lung injury
- Chapter 17 Chronic obstructive pulmonary disease and diseases of the airways
- Chapter 18 Pulmonary vascular pathology
- Chapter 19 Pulmonary vasculitis and pulmonary hemorrhage syndromes
- Chapter 20 The pathology of lung transplantation
- Chapter 21 The lungs in connective tissue disease
- Chapter 22 Benign epithelial neoplasms and tumor-like proliferations of the lung
- Chapter 23 Pulmonary pre-invasive disease
- Chapter 24 Epidemiological and clinical aspects of lung cancer
- Chapter 25 Lung cancer staging
- Chapter 26 Immunohistochemistry in the diagnosis of pulmonary tumors
- Chapter 27 Adenocarcinoma of the lung
- Chapter 28 Squamous cell carcinoma of the lung
- Chapter 29 Large cell carcinoma and adenosquamous carcinoma of the lung
- Chapter 30 Salivary gland neoplasms of the lung
- Chapter 31 Neuroendocrine tumors and other neuroendocrine proliferations of the lung
- Chapter 32 Sarcomatoid carcinomas and variants
- Chapter 33 Mesenchymal and miscellaneous neoplasms
- Chapter 34 Pulmonary lymphoproliferative diseases
- Chapter 35 Metastases involving the lungs
- Chapter 36 Diseases of the pleura
- Index
- References
Chapter 12 - Hypersensitivity pneumonitis
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Dedication
- Contents
- Contents
- Contributors
- Foreword to the First Edition
- Preface to the Sixth Edition
- Acknowledgements
- Chapter 1 The normal lung: histology, embryology, development, aging and function
- Chapter 2 Lung specimen handling and practical considerations
- Chapter 3 Congenital abnormalities and pediatric lung diseases, including neoplasms
- Chapter 4 Pulmonary bacterial infections
- Chapter 5 Pulmonary viral infections
- Chapter 6 Pulmonary mycobacterial infections
- Chapter 7 Pulmonary mycotic infections
- Chapter 8 Pulmonary parasitic infections
- Chapter 9 Acute lung injury
- Chapter 10 Interstitial lung diseases
- Chapter 11 Metabolic and inherited connective tissue disorders involving the lung
- Chapter 12 Hypersensitivity pneumonitis
- Chapter 13 Sarcoidosis
- Chapter 14 Occupational lung disease
- Chapter 15 Eosinophilic lung disease
- Chapter 16 Drug- and therapy-induced lung injury
- Chapter 17 Chronic obstructive pulmonary disease and diseases of the airways
- Chapter 18 Pulmonary vascular pathology
- Chapter 19 Pulmonary vasculitis and pulmonary hemorrhage syndromes
- Chapter 20 The pathology of lung transplantation
- Chapter 21 The lungs in connective tissue disease
- Chapter 22 Benign epithelial neoplasms and tumor-like proliferations of the lung
- Chapter 23 Pulmonary pre-invasive disease
- Chapter 24 Epidemiological and clinical aspects of lung cancer
- Chapter 25 Lung cancer staging
- Chapter 26 Immunohistochemistry in the diagnosis of pulmonary tumors
- Chapter 27 Adenocarcinoma of the lung
- Chapter 28 Squamous cell carcinoma of the lung
- Chapter 29 Large cell carcinoma and adenosquamous carcinoma of the lung
- Chapter 30 Salivary gland neoplasms of the lung
- Chapter 31 Neuroendocrine tumors and other neuroendocrine proliferations of the lung
- Chapter 32 Sarcomatoid carcinomas and variants
- Chapter 33 Mesenchymal and miscellaneous neoplasms
- Chapter 34 Pulmonary lymphoproliferative diseases
- Chapter 35 Metastases involving the lungs
- Chapter 36 Diseases of the pleura
- Index
- References
Summary
Introduction
Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis (EAA), is a pulmonary disease typically manifested in the sensitized host by cough and dyspnea. It results from repeated inhalational exposure to any of numerous identified environmental antigens. The exposure context may be occupational, recreational or domestic. The antigens are classically small organic substances derived from animal, avian and fungal proteins, although a number of low molecular weight chemical compounds are also implicated. Hypersensitivity pneumonitis, in its various subsets, is immunologically mediated. In susceptible hosts, it produces a hypersensitivity reaction in the lung involving inflammation, stereotypically granulomatous, of the small airways (bronchiolitis), the alveolar parenchyma and airspaces. Hypersensitivity pneumonitis is to be distinguished from other inhalatory pulmonary injuries, such as “organic dust toxic syndrome” (pulmonary mycotoxicosis, silo-unloader's syndrome). Hypersensitivity pneumonitis has been characterized as a “multifaceted” disorder and its clinical and pathological expressions may overlap with other lung conditions, presenting as diffuse acute, subacute or chronic interstitial disease.
Classification
The heterogeneous modes of clinical presentation of HP are reflected by different classification systems currently in use. The traditional scheme includes acute, subacute and chronic phases. In an attempt to accommodate the more protean aspects of the disease, more recent interpretations suggest “acute progressive”, “acute intermittent non-progressive” and “recurrent non-acute disease” patterns (Table 1). It may be difficult to distinguish with precision the various clinical phases of HP and it is likely that clinical variability is more related to host factors and circumstances of exposure rather than individual antigen characteristics. It is also important to acknowledge that acute disease does not necessarily progress to chronic, despite the continued presence of an offending antigen. Subclinical disease is also recognized, wherein immunological and inflammatory processes are present in the host, without symptomatology.
- Type
- Chapter
- Information
- Spencer's Pathology of the Lung , pp. 439 - 474Publisher: Cambridge University PressPrint publication year: 2000
References
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