Pathology Flashcards
(18 cards)
UIP: characteristics and diseases
IPF, c.t. disorders, asbestosis, chronic HP
Geographic Heterogeneity
Temporal Heterogeneity (Fibroelastic Foci - bluer, looser, hypercellular, younger)
More severe in subpleural regions
NSIP: characteristics and diseases
idiopathic NSIP, autoimmune (RA, Scleroderma)
Temporally and Geographically UNIFORM fibrosis
Uniformly thickened alveolar septate with fibrotic collagen
Sarcoidosis (pathology)
Extrapulmonary involvement common (eye, skin, spleen)
Well-formed non-necrotizing, non-inflammatory granulomas (compact naked granulomas), typically along bronchovascular structures
Must first rule out infectious etiologies with stains/cultures
Hypersensitivity Pneumonitis (acute vs. chronic)
acute sx: fever, cough, dyspnea
chronic sx: progressive respiratory failure
acute: poorly-formed non-necrotizing granulomas w/ LOTS lymphocytes, plasma cells, giant cells, typically around airways
chronic: UIP
Honeycomb Lung (diseases, pathology)
end-stage form of fibrosis in restrictive lung disease (assoc w/ UIP)
gross: fibrosis and cystic dilated spaces, dense fibrosis and loss of normal lung architecture
histo: cystic spaces lined with columnar bronchial epithelial cells (not pneumocytes)
COPD (emphysema vs. chronic bronchitis)
Emphysema: softer and more compressible, large overinflated lung; large alveolar spaces w/o inflammation, free-floating septate
can be centriacinar (smoking - resp bronchiole), distal acinar (alveolus/duct), or panacinar (A1AT gene deficiency, whole thing)
CB: chronic airway inflammation (high density inflammatory cells in submucosal glands), mucous gland hypertrophy (Reid Index > 0.4 [mucus gland size:epi to cartilage])
Bronchiectasis (what is it, path)
Not a disease, but a process of airway dilatation that complicates other diseases
Gross: large airspaces in periphery
Histo: airways > blood vessel, airway irregular shape and loss of normal wall, accumulations in airway (mucus, inflammatory cells)
Asthma (path: acute v. chronic)
acute: eosinophils (Charcot Leyden Crystals), mucus plugging, churchman spiral (abnormal mucus production)
chronic: basement membrane thickening, smooth muscle hyperplasia, airway fibrosis
Acute Lung Injury (Etiology, Path)
E: Infection, Physical Injury, Inhaled Irritants, Chemical/Drug Injury
Path: DAD - intraalveolar dense pink/eosinophilic hyaline membrane, increased inflammatory cells, interalveolar exudate (necrotic cells, fibrin, other plasma proteins)
Bacterial Pneumonia (Path)
- Patchy (bronchopneumonia) or diffuse (lobar pna)
- parenchyma is firm, congested, consolidated (hepatization due to exudate/edema)
- Numerous sheets of NEUTROPHILS and hyaline membranes in alveolar spaces
Viral Pneumonia (Path)
- LYMPHOID infiltrate w/in alveolar septate/interstitium (nothing in alveolar spaces)
- may see viral inclusions in CMV (large purple balls in cells); or glassy chromatin in herpes (multinucleated macrophages, chromatin margination)
Chronic Granulomatous Infections (Etiologies, Path)
E: Mycobacterial (TB) and fungal (histo, blasto, cocci)
P: 1. Granuloma + Inflammation (+/- necrotic core: multinucleated giant cell or granular eosinophilic+basophilic cell debris in center)
2. Staining: Silver GMS stain: fungi (black)
Acid Fast Bacilli (AFB): mycobacteria (red)
Adenocarcinoma (Type, Path)
Most common form of NSCLC
Esp in NON-Smokers
Peripheral Tumors
1. Gland formation (single layer of columnar epithelium)
2. Mucin Production (pale blue intracellular)
3. Immunoreactive for TTF1 (antibodies against tumor cell - look brown)
Tx: mLc testing for driver mutations key for precision therapy
Squamous Cell Carcinoma (type, path)
2nd most common form NSCLC, esp in SMOKERS
Large Central Tumors
1. Keratinization (abundant dense pink - intra and extracellular)
2. Intracellular Bridges
3. TTF1 Negative
Large Cell Carcinoma (type, path)
Wastebasket category
No evidence of squamous or glandular differentiation
Poorly differentiated tumors, no specific features
Small Cell Carcinoma (type, path)
SCLC Assoc with smoking - bulky mediastinal disease with distant mets Poor prognosis with chemotherapy NEUROENDOCRINE DIFFERENTIATION 1. High nucleus:cytoplasm ratio 2. Lots of Mitotic Figures 3. Dark Granular Chromatin w/o nuclei
Carcinoid Tumor (type, path)
NOT assoc with smoking,
Usually indolent centrally placed tumor - often endobronchial (w/in airway) - may metastacize
NEUROENDOCRINE DIFFERENTIATION
1. Low nucleus:cytoplasm ratio
2. Nested Growth
3. Granular “Salt & Pepper” Chromatin
Pleural Tumors (Type, Assoc)
Malignant Mesothelioma Arises from mesothelium on pleural/peritoneal surfaces Assoc with asbestos exposure Very poor prognosis Path: Difficult to identify
