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MODHIII - Unit 3 > Pulmonary Pathology > Flashcards

Flashcards in Pulmonary Pathology Deck (37)
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1

Anatomic patterns of pneumonia

- patchy: bronchopneumonia
- whole lobe: lobar pneumonia

2

Pathologic stages of bacterial pneumonia

- congestion
- red hepatization
- gray hepatization
- resolution

3

Congestion stage of bacterial pneumonia

- gross lung: heavy, boggy, red
- microscopic: vascular engorgement, intra-alveolar fluid, FEW neutrophils, numerous bacteria

4

Red hepatization stage of bacterial pneumonia

- gross lung: red, firm, airless, liver-like consistency
- microscopic: exudate composed of neutrophils, red cells, and fibrin; filling alveolar spaces

5

Gray hepatization stage of bacterial pneumonia

- gross lung: grayish brown, dry surface
- microscopic: disintegration of red blood cells, persistence of fibropurulent exudate

6

Resolution stage of bacterial pneumonia

- microscopic: enzymatic digestion of alveolar exudate to produce granular, semifluid debris that gets resorbed, ingested by macrophages, expectorated or organized by fibroblasts growing into it

7

Complications of pneumonia paired with pathologic process

- destruction and necrosis w/ accumulation of neutrophils--abscess
- spread of infection to pleural cavity--empyema (intrapleural fibrinosuppurative reaction)
- spread of infection via blood vessels--bacteremic dissemination (heart valves, brain, kidney)

8

Best example of microorganism for bacterial pneumonia

streptococcus pneumonia

9

Best example of atypical bacterial pneumonia

mycoplasma pneumonia

10

Viral/atypical bacterial pneumonia pathology

- infection that leads to inflammation of interstitium
- inflammatory infilitrate compose of LYMPHOCYTES, histiocytes, plasma cells

11

Viral pneumonia causes

- influenza A and B
- respiratory syncytial virus (RSV)
- human metapneumovirus
- adenovirus
- rhinovirus, rubeola, varicella

12

Different histologic findings in pneumonia: bacterial vs. viral

Bacterial: located in alveolar spaces, neutrophils
Viral: located in interstitium, lymphocytes

13

Histologic features of usual interstitial pneumonia

- hetergeneity of interstitial fibrosis
- fibroblastic foci
- honeycomb fibrosis

14

Histologic features of hypersensitivity pneumonitis

- poorly formed granulomas: non caseating
- interstitial pneumonitis consisting of lymphocytes, plasma cells, macrophages
- interstitial fibrosis and honeycombing (late stage)

15

Key association with hypersensitivity pneumonitits

BIRDS ARE BAD

16

Gross lung appearance in sarcoidosis

- multiple small white nodules many next to airways

17

Histologic features of Sarcoidosis

- non caseating granulomas
- asteroid body
- schaumann body

18

Location of non necrotizing granulomas in sarcoidosis

- beneath pleura
- along interlobular septa
- bronchovascular bundles

19

Three most common lung carcinomas

- non small cell carcinoma: adenocarcinoma, squamous cell carcinoma
- small cell carcinoma

20

Male to female ratios of lung carcinoma

- adenocarcinoma: males 37%, females 47%
- squamous cell carcinoma: males 32%, females 25%
- small cell carcinoma: males 14%, females 18%

21

5 year survival rate of lung carcinomas

- non small cell carcinoma: 21.4%
- small cell carcinoma: 6.5%

22

Metastatic carcinoma differences

- more common than primary lung cancer
- most commonly presents as multiple bilateral nodules (vs. primary lung cancer that usually presents as a solitary lesion)

23

Squamous cell carcinoma location and histologic findings

- location: centrally in the mainstem, lobar or segmental bronchi
- features: keratinization (eosinophilic dense cytoplasm), pearl formation, intercellular bridges

24

Small cell carcinoma location and histologic findings

- location: central or peripheral
- small cells, scant cytoplasm, granular nuclear chromatin (salt and pepper pattern), high mitotic rate, nuclear molding

25

Lung carcinomas arising from neuroendocrine cells

- small cell carcinoma
- carcinoid

26

Carcinoid carcinoma

- low grade malignant epithelial neoplasms
- based on number of mitosis and/or presence of necrosis divided into: typical and atypical
- good 5 year survival: typical-87%, atypical-56%
***NOT PRECURSORS OF SMALL CELL CARCINOMA***

27

5 year survival of small cell carcinoma: why

- 6.5%
- very aggressive behavior

28

Carcinomas associated with smoking

- small cell carcinoma
- squamous cell carcinoma

29

Mutation seen commonly with adenocarcinoma

- EGFR mutation

30

Adenocarcinoma location and histologic features

- location: peripheral
- features: gland formation, mucin production

31

Bronchioloalveolar carcinoma

- old name for non invasive adenocarcinoma
- not in new WHO classification

32

Mesothelioma

- rare tumor of PLEURA (not parenchyma)
- asbestos exposure is cause
- very pore outcome

33

Bronchioloalveolar carcinoma (BAC) histologic features and subtypes

- grow along intact alveolar walls
- no invasion
- subtypes: mucinous, non mucinous

34

Name for growth pattern in bronchioloaveolar carcinoma

lepidic

35

Mesothelioma stats

- rare malignant tumor of mesothelial origin
- 90% asbestos related
- latent period 20-45 years

36

Key histologic feature of asbestos exposure

- asbestos body: asbestos fiber coated w/ iron protein complex, found in lung tissue

37

Histologic findings of bacterial pneumonia

- intra-alveolar exudate: fibrin, neutrophils
- congestion of alveolar capillaries