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
