Smoking-associated interstitial lung disease: update and review

Expert Rev Respir Med. 2020 Aug;14(8):825-834. doi: 10.1080/17476348.2020.1766971. Epub 2020 May 22.

Abstract

Introduction: Smoking-associated interstitial lung disease manifests as several heterogeneous disorders involving the airways, pleura, and lung parenchyma with various radiological patterns. The clinical history, radiologic, and pathologic findings are important to distinguish these more uncommon diseases. A multidisciplinary approach is recommended for diagnosis and to manage these conditions appropriately.

Areas covered: This review provides an overview of the epidemiology, risk factors, pathogenesis, clinical features, diagnosis, and treatment of acute eosinophilic pneumonia, e-cigarettes, or vaping associated lung injury, respiratory bronchiolitis interstitial lung disease, desquamative interstitial pneumonitis, pulmonary Langerhans cell histiocytosis, idiopathic pulmonary fibrosis, and combined pulmonary fibrosis emphysema.

Expert opinion: Cigarette smoking is associated with a variety of pathologic conditions that affect the airways and lungs. E-cigarette use and vaping present new challenges to the clinician. Consensus between the clinical, radiographic, and pathologic findings is important in identifying and differentiating between the various entities to properly diagnose smoking-related interstitial lung diseases discussed in this review.

Keywords: Lung disease; bronchiolitis; emphysema; fibrosis; histiocytosis; interstitial Lung disease; langerhans-Cell; smoking; vaping.

Publication types

  • Review

MeSH terms

  • Bronchiolitis
  • Electronic Nicotine Delivery Systems
  • Humans
  • Idiopathic Pulmonary Fibrosis
  • Lung / pathology
  • Lung Diseases, Interstitial / chemically induced*
  • Lung Diseases, Interstitial / epidemiology
  • Lung Diseases, Interstitial / etiology
  • Lung Diseases, Interstitial / pathology
  • Pulmonary Emphysema
  • Pulmonary Eosinophilia
  • Risk Factors
  • Smoking / adverse effects*