Histopath - Resp Flashcards
What does neoplasm mean?
Abnormal cell growth
What is Asthma?
A condition in which breathing is periodically difficult due to widespread narrowing of the airways - changes in severity over short periods of time
Histopathology of asthma
Airway remodelling with smooth muscle hypertrophy, goblet cell hyperplasia, and eosinophilia in severe cases
What are the 2 components of COPD?
Chronic bronchitis (coughing) and emphysema (issues with alveoli)
Histopathology of COPD
neutrophilic infiltration into airways,
loss of alveoli, elastic fibres, and lung parenchyma
How does alpha-1 antitrypsin deficiency present?
- Young
- Non-smoker
- Non-drinker
- SOB
- Abdo distension
- Spider naevi
What is the cause of CF?
Autosomal recessive mutation in CFTR gene on chromosome 7
Mutation leads to defective ion transport –> excessive resorption of water from secretions of exocrine glands –> abnormally thick mucous secretions –> affects all organ systems
What are common complications of CF?
- Recurrent lung infections
- Pancreatic insufficiency
- Malabsorption
Histopathology of CF
mucous clogged airways and inflammatory cell infiltration
What is bronchiectasis?
Pathological airway dilation secondary/reactive to recurrent infections
Histopathology of bronchiectasis?
Dilated fibrotic airways with mucous plugging
What is pulmonary oedema?
Accumulation of fluid in alveolar spaces as a consequence of ‘leaky capillaries’ or ‘back pressure’ from failing ventricles
Causes of pulmonary oedema
- Left heart failure
- Alveolar injury
- High altitude
Histopatholog of pulmonary oedema
Acute = heavy, watery lungs + intra-alveolar fluid
Chronic = iron-laden macrophages (heart failure cells), fibrosis
What is diffuse alveolar damage?
Acute diffuse lung injury in which patients present with rapid onset of respiratory failure, requiring ventilation on ITU
(ARDS in adults)
Diffuse alveolar damage CXR finding
White out all lung fields
Pathogenesis of diffuse alveolar damage
Acute damage to alveolar endothelium and/or epithelium leading to exudative inflammatory reaction
Which types of patients tend to get bronchopneumonia as opposed to lobar?
Comprimised host defences
What type of organisms usually cause bronchopneumonia?
Low-virulence organisms: staphylococcus, haemophilus, streptococcus, pneumococcus
Histopathology of bronchopneumonia
Patchy bronchial and peribronchial distribution, acute inflammation surrounding airways and within alveoli
What is lobar pneumonia?
Acute bacterial infection of a large portion of a lobe
or entire lobe
What type of organism usually causes lobar pneumonia?
High virulence organisms, e.g., Strep. pneumoniae
Histopathology of lobar pneumonia
Widespread fibrinosuppurative consolidation
What is a fibrosing lung disease?
Chronic and progressive fibrosing diseases of the lung
What are the main 3 types of fibrosing lung disease?
- Idiopathic pulmonary fibrosis / cyptogenic fibrosing alveolitis
- Extrinsic allergic alveolitis/farmers lung
- Organic allergens
- Industrial lung disease/pneumoconiosis
- Caused by breathing in specific dusts in workplace
What is the gold standard Ix for pulmonary fibrosis?
HRCT (high res CT) ±biopsy
What spirometry pattern do fibrosing lung diseases show?
Restrictive
What is a pulmonary thromboembolism?
Embolisation of peripheral thrombus to the lung
What is a common site formation of pulmonary thromboembolism?
Deep veins of the leg
RFs fro Pulmonary thromboembolism
- obesity
- immobility
- pregnancy
- malignancy
- surgery
- advanced age
- thrombotic diseases
Proportion of lung ca which are small cell cancers
20%
What RF is small cell lung ca closely associated with?
Smoking
Where are small cell lung cancers often found?
Centrally near bronchi
Which mutations is small cell lung cancer associated with?
P53 and RB1 (retinoblastoma)
Prognosis for small cell lung cancer?
Poor
(As highly malignant -> quick mets)
Histopathology of small cell lung cancer
Small, poorly differentiated ‘oat cells’
What are 3 paraneoplastic syndromes of small cell lung cancer?
SIADH, Lambert-Eaton, Cushing’s
What are the three types of non-small cell lung cancers?
Adenocarcinoma, squamous cell carcinoma, large cell carcinoma
Which type of lung cancer is most common in non-smokers?
Adenocarinoma
(++F>M)
Where are adenocarcinomas often located?
Peripherally
Which mutations is adenocarcinoma associated with?
KRAS and EGFR
Which lung cancer has the biggest association with smoking?
Squamous cell carcinoma
Where are squamous cell carcinomas often found?
Originating from bronchi
Which mutation is squamous cell carcinoma associated with?
p53
Which paraneoplastic syndrome is squamous cell carcinoma associated with?
Hypercalcaemia of malignancy (PTHrp)
Histopathology of large cell carcinoma
- Poorly differentiated tumours (composed of large cells)
- No evidence of glandular or squamous differentiation
*Which lung ca is associated w hyponatraemia?
small-cell lung ca
*Which ca does asbestos cause?
Mesothelioma
*MUcous producing lung ca
Mucinous adenocarcinoma
