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Anatomic pathology > Lung > Flashcards

Flashcards in Lung Deck (452)
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60

Follicular bronchiolitis: Associations.

Anything that causes lymphoid hyperplasia, e.g. chronic inflammation, infections.

61

Diffuse alveolar damage: Clinical equivalents (3).

Acute respiratory-distress syndrome.

Acute interstitial pneumonia.

Acute lung injury.

62

Diffuse alveolar damage: Relevance to autoimmune disease (2).

Various collagen-vascular diseases cause DAD-type inflammation.

Various vasculitides can resemble AIP clinically.

63

Diffuse alveolar damage: Distribution of lesions (2).

Patchy involvement of the lung, but concentrated in the lower lobes.

Diffuse involvement of the alveolus.

64

Diffuse alveolar damage: Radiography.

Ground-glass opacities that spare the lobules.

65

Diffuse alveolar damage: Phases.

Exudative: First week.

Proliferative: Second week.

Fibrotic: Late.

66

Diffuse alveolar damage, exudative phase: Histology.

Hyaline membranes and interstitial edema.

67

Diffuse alveolar damage, proliferative phase: Histology.

Interstitium and airspaces: Florid proliferation of fibroblasts, myofibroblasts, type 2 pneumocytes.

Arteries: Intimal proliferation, medial hypertrophy.

68

Diffuse alveolar damage, fibrotic phase: Histology.

Dense interstitial fibrosis with microcysts.

69

Diffuse alveolar damage vs. usual interstitial pneumonia (3).

UIP:

− No hyaline membranes.
− Temporal heterogeneity of fibrosis.
− Fibrosis has more collagen and fewer cells.

70

Acute respiratory-distress syndrome: Prognosis.

Most patients regain near-normal lung function.

71

Acute interstitial pneumonia:

A. Clinical presentation.
B. Prognosis.

A. Resembles severe community-acquired pneumonia but does not respond to antibiotics.

B. Death in 6 months in 78% of cases.

72

Cryptogenic organizing pneumonia:

A. Clinical presentation.
B. Duration.

A. Cough, dyspnea, and flulike symptoms.

B. Subacute.

73

Cryptogenic organizing pneumonia: Prognosis.

Usually responds to steroids.

74

Cryptogenic organizing pneumonia: Distribution of lesions.

Subpleural.

75

Cryptogenic organizing pneumonia: Radiography.

Peribronchial consolidation and nodularity.

76

Cryptogenic organizing pneumonia: Histology (2).

Masson bodies: Intraluminal plugs consisting of young fibrous tissue.

Interstitial mild chronic inflammation with foci of foamy macrophages.

77

Cryptogenic organizing pneumonia: Special stain.

Movat's stain: Masson bodies appear green; dense fibrosis would appear yellow.

78

Cryptogenic organizing pneumonia vs. usual interstitial pneumonia.

UIP:

− Dense fibrosis (not seen in COP).
− Fibroblastic foci are interstitial, not intraluminal.
− Temporal heterogeneity of fibrosis.

79

Cryptogenic organizing pneumonia vs. nonspecific interstitial pneumonia.

NSIP: Interstitial chronic inflammation without Masson bodies.

80

Usual interstitial pneumonia:

A. Clinical presentation.
B. Duration.

A. Progressive dyspnea and cough.

B. Chronic.

81

Usual interstitial pneumonia:

A. Associated environmental agents (3).
B. Associated inherited diseases (2).

A. Cigarettes, asbestos, drugs.

B. Familial idiopathic pulmonary fibrosis, Hermansky-Pudlak syndrome.

82

Usual interstitial pneumonia: Association that imparts a better prognosis.

Collagen-vascular disease.

83

Usual interstitial pneumonia: Prognosis.

Median survival is 3 years.

84

Usual interstitial pneumonia: Distribution of lesions (2).

Subpleural.

Lower lobes.

85

Usual interstitial pneumonia: Radiography (3).

Honeycombing.

Ground-glass opacities.

Traction bronchiectasis.

86

Usual interstitial pneumonia: Histology.

Temporal heterogeneity: The same area may contain both mature fibrosis and subepithelial young fibrosis (fibroblastic foci).

Spatial heterogeneity: Some areas are affected, some not.

87

Usual interstitial pneumonia: Histologic findings associated with poor prognosis (4).

Diffuse alveolar damage.

Infection.

Capillaritis.

Organizing pneumonia.

88

Usual interstitial pneumonia vs. hypersensitivity pneumonitis with fibrosis.

Hypersensitivity pneumonitis:

− Mainly upper lobes.
− Centered on bronchioles.
− More cellular inflammation, including giant cells or poorly formed granulomas.

89

Usual interstitial pneumonia vs. Langerhans' cell histiocytosis.

Langerhans' cell histiocytosis:

− Centered on bronchioles.
− Few or no fibroblastic foci.