Oorzaken
I) Bekende oorzaken:
- inhalatie van stof uit beroep of omgeving (bv. pneumoconiose) -
bestraling
- medicatie - infecties
- maligniteit (lymfangitis carcinomatose, lymfoom long of uitzaaiing langs
LV thv interstitium)
II) Onbekende etiologie:
Oa sarcoïdose, idiopathische longfibrose (IPF) …
IPF = idiopathische longfibrose
Verloop / Traag progressieve afname in longfunctie en levensduur mét acute
prognose exacerbaties
Gemiddeld 3 à 5 jaar (slechte prognose)
Wanneer combi met emfyseem in bovenkwab (vaak ex-rokers) sneller
progressief!
Kliniek => progressief verergerende dyspnoe en droge hoest
KO Fijne crepitaties: bibasaal eind-inspiratoir
Soms clubbing (horlogeglasnagels)
Pt Oudere Pt, vaak (ex-)roker
Diagnose Longbiopt (thoracoscopisch / open) MAAR is invasief
=> kliniek+ duidelijk CT beeld ook goed
Beeldvorm RX: reticulaire patronen (perifeer) => honingraat (eindstadium)
ing CT/ HRCT: matglasaspect (beginfase) – in buiklig (vnl
onderkwabben)
2
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