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.
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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
