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Flashcards in Lung Deck (452)
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420

Pulmonary Langerhans'-cell histiocytosis: Histology (4).

Stellate or Medusa-head nodules centered on bronchioles.

Nodules consist of Langerhans' cells (grooved nuclei), eosinophils, lymphocytes, plasma cells.

Nodules may invade vessels.

Progression from cellular nodules to fibrotic scars.

421

Pulmonary Langerhans'-cell histiocytosis: Associated histologic finding.

Respiratory bronchiolitis.

422

Pulmonary Langerhans'-cell histiocytosis: Expressed cytokines (2).

TGF-β₁.

GM-CSF.

423

Langerhans' cells: Immunohistochemistry.

Positive: S-100, CD1a, Langerin.

Negative: CD68.

424

Reactive eosinophilic pleuritis:

A. Cause.
B. Histology.

A. Pneumothorax.

B. Eosinophils mixed with proliferating mesothelial cells and mononuclear cells.

425

Post-transplantation lymphoproliferative disorder: Definition.

Abnormal lymphocytic proliferation (benign or malignant) occurring during immunosuppression and often involving the transplanted organ.

426

Post-transplantation lymphoproliferative disorder: Origin of proliferating cells.

Bone marrow: The donor.

Solid organs: The recipient.

427

Post-transplantation lymphoproliferative disorder: Timing.

Occurs 1 month to 4 years after the transplantation.

428

Post-transplantation lymphoproliferative disorder: Viral association.

EBV.

429

Post-transplantation lymphoproliferative disorder in the lung: Types.

Plasmacytic hyperplasia.

Polymorphic lymphoproliferative disorder.

Malignant lymphoma or multiple myeloma.

430

PTLD of the lung: Association of type with age.

Plasmacytic hyperplasia is the most common type in children and young adults.

431

PTLD of the lung: Histology of plasmacytic hyperplasia.

Proliferation of small polyclonal T and B lymphocytes, plasma cells, occasional immunoblasts.

Preserved pulmonary architecture.

432

PTLD of the lung: Histology of polymorphic lymphoproliferative disorder.

Clonal lymphocytes, plasmacytoid cells; immunoblasts that may resemble Reed-Sternberg cells.

Distorted pulmonary architecture.

433

PTLD of the lung: Most common type of lymphoma.

Diffuse large B-cell lymphoma.

434

Post-transplantation lymphoproliferative disorder: Treatment.

Reduction in immunosuppression during the first year after transplantation.

435

Malignant mesothelioma: Prognosis (2).

Death in <1 year; a few months later for epithelioid mesothelioma.

436

Malignant mesothelioma: Relation to smoking.

Smoking does not increase the risk of mesothelioma.

Smoking + asbestos = greatly increased risk for lung carcinoma.

437

Malignant mesothelioma: Variants.

Epithelioid.

Sarcomatoid.

Biphasic.

438

Epithelioid mesothelioma: Cytology.

Bland, homogeneous.

Nuclei: Round, vesicular; large nucleolus.

439

Epithelioid mesothelioma: Histology.

Grows in tubules, papillae, glands or acini, solid sheets, or a combination of patterns.

440

Desmoplastic mesothelioma:

A. Definition.
B. Frequency.

A. A collagenous subtype of sarcomatoid mesothelioma.

B. Makes up about 10% of malignant mesothelioma.

441

Biphasic mesothelioma: Criterion.

The tumor must be at least 10% epithelioid and at least 10% sarcomatoid.

442

Malignant mesothelioma: Most common variant.

Epithelioid.

443

Malignant mesothelioma: "Specific" markers (4).

Calretinin.

CK5/6.

WT-1.

D2-40.

444

Malignant mesothelioma: Nonspecific markers (2).

Pancytokeratin.

CK7.

445

Malignant mesothelioma: Mutation.

Homozygous deletion of CDKN2A/ARF at 9p21.

446

Malignant mesothelioma: Best immunohistochemical marker and its interpretation.

Calretinin:

- Stains cytoplasm of all mesothelial cells.
- Stains nuclei of malignant mesothelioma.

447

Malignant mesothelioma vs. reactive mesothelial hyperplasia: Histology.

Reactive mesothelial hyperplasia does not invade the parietal pleural fat.

448

Malignant mesothelioma vs. reactive mesothelial hyperplasia: Immunohistochemistry (4).

Reactive mesothelial hyperplasia: Cytoplasmic desmin.

Malignant mesothelioma: Linear EMA, strong p53, GLUT1.

449

Desmoplastic mesothelioma vs. chronic fibrosing pleuritis.

Chronic fibrosing pleuritis: Combinations of cytokeratins demonstrate orderly growth and absence of invasion of pleural fat.