9/23- Pathology Review Flashcards Preview

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Flashcards in 9/23- Pathology Review Deck (47)
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31

What are the microscopic and gross findings of asbestosis?

Microscopic:

- Patchy interstitial and subpleural fibrosis (fibers stimulate release of mediators leading ot repeated cycles of inflammation/fibrosis)

- Starts around resp bronchioles and alveolar ducts; proceeds distally

- Fibrosis similar to UIP, but should see asbestos bodies! (asbestos fiber + iron-protein coat; look like dumbbell beaded bodies)

- Honeycombing

Grossly:

- Visceral pleural thickening

- Most commonly affects lower lobes

32

Where do pleural plaques commonly form?

- Parietal pleura

- Domes of diaphragm

33

What are pleural plaques made of?

Typically acellular; don't commonly have asbestos bodies

34

What are the microscopic and gross findings of silicosis?

- Early: dust-filled macrophages, lymphatic/bronchovascular distribution

- Later: silicotic nodules (lamellar fiborsis with birefringent silica particles)

- Uniform fibrosis begins around bronchioles

- Can get honeycombing

Grossly: upper lobes

35

What are the microscopic and gross findings of HP?

Acute:

- Neutrophils in alveoli and respiratory bronchioles

- Lasts 1-2 days

Subacute/chronic (3 characteristics you need to know!)

1. Interstitial lymphoplasmacytic infiltrate (beings around bronchioles (~100%)

2. Ill-defined, random, non-caseating granulomas (~67%)- these are more diffuse/less discrete than the granulomas of sarcoidosis

3. Patchy organizing pneumonia (60%)

36

What are the microscopic findings of sarcoidosis?

Microscopic

- Mutliple nodules: pleura, interlobular septa, bronchovascular structures

- Well-formed/defined granulomas:

  • Epithelioid histioctyes
  • Multinucleated giant cells
  • Chronic inflammatory cells

- Usually no necrosis!! (noncaseating)

- Lung architecture preserved

- Must rule out infectious organisms (TB, fungus) before starting to treat sarcoidosis with steroids

37

What are the microscopic findings of COP?

Microscopic:

- Intraluminal plugs of granulation tissue (Masson bodies) in distal airways (bronchioles, alveolar ducts, alveoli)

- Patchy distribution; temporally homogeneous

- Lung architecture preserved

- Inflammation

38

What are the microscopic findings of RB?

- Finely pigmented (dusty brown) macrophages in respiratory bronchioles and adjacent alveolar ducts and alveoli

- Lung architecture preserved

- More?

39

What are the microscopic findings of DIP?

- Diffuse involvement of lung parenchyma

- Large accumulation of alveolar macrophages

- Uniform fibrotic thickening of alveolar septa (mild-moderate)

- Chronic inflammation; overall lung architecture preserved

- No honeycombing

40

What are the ILDs associated with smoking?

- RB: Respiratory Bronchiolitis

- DIP: Desquamative Interstitial Pneumonitis

41

How are lung cancers divided?

How does the treatment vary with each?

- Small cell: chemo and radiation

- Non-small cell: start with surgery if resectable

42

Histological characteristics of squamous cell carcinomas?

- Have stratified squamous organization

- Commonly necrotic; can form ---

- Keratin

43

Histological characteristics of adenocarcinoma?

- Presence of glands

- Mucin production (if no glands seen, may have to stain for mucin)

44

What are the 2 types of AIS?

Adenocarcinoma in situ

1. Mucinous

2. Non-mucinous

(Can only say AIS if entire resection and no vascular or septal invasion.. otherwise adenocarcinoma "with lepidic growth pattern")

45

Histological characteristics of small cell carcinoma?

- Hyperchromatic cells

- Indistinct nucleoli

- Nuclear indentation/hugging

- Necrosis (?)

46

Histological characteristics of typical carcinoid tumor?

- Bland looking cells

- Rich vascular tissue

- Chromogranin stain shows NE

47

Stain for large cell NE tumor?

CD56+