Flashcards in Lung Deck (452)
Radiation pneumonitis: Typical cells (2).
Foam cells: Lipid-rich cells with features of macrophages and smooth-muscle cells.
Radiation fibroblasts: Stromal cells with atypical nuclei and much blue cytoplasm.
Radiation pneumonitis: Prognosis (2).
Acute pneumonitis usually responds to corticosteroids.
Carcinoma may arise after >10 years.
A. Less than 5%.
B. The lungs are relatively deficient in hydrolase, which detoxifies bleomycin.
Bleomycin toxicity: Exacerbating factors (3).
Cyclophosphamide and other drugs.
Bleomycin toxicity: Radio-recall phenomenon
Bleomycin can unmask damage to lungs caused by previous irradiation.
Bleomycin toxicity: Histology.
Diffuse alveolar damage.
Atypia of pneumocytes.
Progression to nonuniform fibrosis in some patients.
Amiodarone toxicity: Histology.
Diffuse alveolar damage.
Hyperplasia of type 2 pneumocytes.
Foamy histiocytes in airspaces.
Amiodarone toxicity: Electron microscopy.
Lamellar inclusions in alveolar macrophages.
Methotrexate toxicity: Histology.
Poorly formed granulomas.
Interstitial inflammation that includes eosinophils.
Wegener's granulomatosis: Clinical triad.
Disease of upper airways (e.g. sinusitis).
Disease of lower airways.
Wegener's granulomatosis: Affected sites (3).
Head and neck.
Wegener's granulomatosis: Autoantibody.
c-ANCA in most: Usually against proteinase 3.
Wegener's granulomatosis in the lungs: Distribution of lesions.
Mostly in the lower lobes.
Wegener's granulomatosis in the lungs: Gross pathology.
Many nodules of variable size.
Cavitation in half of cases.
Wegener's granulomatosis in the lungs: Histology (5).
Palisades of histiocytes.
Vasculitis of small vessels.
Wegener's granulomatosis in the lungs: Special stain.
Elastic stain: Destruction of elastic lamina.
Wegener's granulomatosis vs. Churg-Strauss syndrome (5).
− Eosinophilia in blood and tissues is typical.
− Asthma is typical.
− Cardiac disease is common.
− Renal disease is mild.
− Sinus disease is mild.
Churg-Strauss syndrome: Clinical tetrad.
Churg-Strauss syndrome: Autoantibody.
p-ANCA in some: Usually against myeloperoxidase.
Churg-Strauss syndrome in the lungs: Gross pathology (4).
Eosinophilic pleural effusion.
Stellate peripheral pulmonary arteries.
Cavitation is rare.
Churg-Strauss syndrome in the lungs: Histology (4).
Extravascular granulomas with central necrosis.
Churg-Strauss syndrome in the lungs: Pharmacological differential diagnosis.
Churg-Strauss syndrome in the lungs: Microbiological differential diagnoses.
Pulmonary arterial hypertension: Associations with systemic diseases (4).
Systemic lupus erythematosus.
Pulmonary hypertension: Symptoms (5).
Hemoptysis is rare.
Pulmonary hypertension: Leading cause.
Left-sided heart failure.
B. Gross pathology.
A. Pulmonary systolic pressure >25 mmHg.
B. Pulmonary atherosclerosis.
Grading scheme for pulmonary hypertension: Use.
Applies only to idiopathic pulmonary hypertension and to certain types of secondary pulmonary hypertension ("APAH").
Grading scheme for pulmonary hypertension: Histology of Grade I (2).
Medial hypertrophy of pulmonary arteries.
Extension of muscle into walls of pulmonary arterioles.