Flashcards in Lung Deck (452)
Grading scheme for pulmonary hypertension: Histology of Grade III (3).
Grade I plus subendothelial fibrosis.
Small arteries and arterioles: Concentric masses of fibrous tissue, reduplication of elastic lamina, occlusion of vascular lumens.
Large arteries: Atherosclerosis.
Grading scheme for pulmonary hypertension: Histology of Grade IV (3).
Medial hypertrophy is less apparent.
Progressive dilatation of small arteries.
Grading scheme for pulmonary hypertension: Histology of Grade V (2).
Plexiform and angiomatoid lesions.
Intraalveolar hemosiderin-laden macrophages.
Grading scheme for pulmonary hypertension: Histology of Grade VI (2).
Necrotizing arteritis with thrombosis.
Transmural infiltrates of neutrophils and eosinophils.
Grading scheme for pulmonary hypertension: Which grades are reversible?
Grades I, II, and III.
Grading scheme for pulmonary hypertension: Which grades are associated with secondary pulmonary hypertension?
Grades I, II, and III.
Pulmonary hypertension due to chronic thrombotic or embolic disease: Histology (3).
Little or no medial hypertrophy.
Eccentric intimal fibrosis with focal obliteration.
Organizing thrombi with recanalization.
Pulmonary hypertension: Mutation.
Familial pulmonary arterial hypertension: BMPR4 on 2q33-q34.
Pulmonary veno-occlusive disease: Age group.
Mostly in children and young adults.
Pulmonary veno-occlusive disease: Distribution of lesions.
Pulmonary venules and small veins in the lobular septa.
Pulmonary veno-occlusive disease: Histology of veins.
Occlusion of affected veins by intimal fibrosis.
Medial hypertrophy ("arterialization") and increase in elastic fibers.
Usually no plexiform lesions or vascular inflammation.
Pulmonary veno-occlusive disease: Additional histology.
Capillaries may be dilated and tortuous, mimicking pulmonary capillary hemangiomatosis.
Hemosiderin may be abundant, mimicking idiopathic pulmonary hemosiderosis.
Pulmonary capillary hemangiomatosis.
Proliferation of capillaries causes thickening of alveolar septa.
CMV pneumonia: Infected cells (4).
Respiratory epithelial cells.
CMV pneumonia: Effect of ganciclovir on histology.
Makes the intranuclear inclusions redder and rounder.
Herpes simplex virus: Respiratory infections.
Necrotizing bronchiolocentric pneumonia.
Interstitial pneumonitis resembling DAD.
Measles virus: Respiratory infections.
A. Cytopathic effects.
B. Respiratory infection.
A. None or multinucleate giant cells.
B. Giant-cell pneumonia (genotypes 2 and 3).
A. Cytopathic effect.
B. Histology of respiratory infection (2).
A. None; virus is identified by IHC or PCR.
B. Marked alveolar edema; immature leukocytes in alveolar capillaries.
Legionella pneumonia: Type of inflammation (3).
Monocytes and macrophages.
All of the above.
Legionella pneumonia: Other histologic features (3).
Intraalveolar fibrin and hemorrhage.
Abundant nuclear debris.
A. Special stain.
B. Other method of detection.
A. Silver stain.
B. Urinary antigen test detects serogroup 1 only.
Nocardia pneumonia: Main route of infection.
Inhalation of bacteria in soil and decaying organic matter.
Nocardia pneumonia: Sites of concurrent infection (4).
Nocardia pneumonia: Histology (3).
Immunocompromised: Poorly formed granulomas rather than abscesses.
Nocardia pneumonia: Special stains (3).
Ghon lesion of pulmonary tuberculosis:
A. 1-2 cm.
B. Necrotic center.
C. Lower upper lobe or upper lower lobe, near the pleura.
Pulmonary tuberculosis: Ghon complex.
Consists of a Ghon lesion and enlarged hilar lymph nodes.
Pulmonary tuberculosis: Ranke complex.
Fibrosis and calcification of the Ghon complex due to cell-mediated immunity.