Histopathology 21: Respiratory Pathology

Question 1

What does pulmonary oedema look like on histology ?

Answer 1

Intra-alveolar fluid

Question 2

What is the name of the neonatal disease in which preterm babies have insufficient surfactant production ?

Answer 2

Hyaline membrane disease of the newborn

Question 3

“On post-mortem examination of the lungs they are heavier than normal, expanded and firm. They are plumb coloured and airless”

Which disease does this describe ?

Answer 3

Acute lung injuries: ARDS or hyaline membrane disease of the newborn

Question 4

List 4 acute changes to the airways in asthma ?

Answer 4

Bronchospasm
Oedema
Hyperaemia
Inflammation

Question 5

List 4 chronic changes to the airways in asthma ?

Answer 5

Muscular hypertrophy
Airway narrowing
Goblet cell hyperplasia
Scarring

Question 6

What are the histological findings of asthma ?

Answer 6

Eosinophils and mast cells 
Hypertrophic goblet cells 
Dilated vessels
Thick muscular layer 
Charcot-Leyden Crystals

Question 7

What are the histological findings of Chronic bronchitis?

Answer 7

Dilated airways
Mucous gland hyperplasia
Goblet cell hyperplasia
Mild inflammation

Question 8

What are the histological findings of emphysema ?

Answer 8

Centrilobular damage to alveolar tissue

Panacinar (if alpha 1 anti trypsin deficiency)

Question 9

List 5 pathologies seen with cystic fibrosis ?

Answer 9

Lungs- Thick mucous with recurrent infections
G.I tract- meconium ileus
Pancreas - pancreatitis 
Liver - cirrhosis 
Male reproductive system - Infertility

Question 10

List histological features of Bronchopneumonia ?

Answer 10

Patchy bronchial/peri bronchial distribution often the lower lobes
Acute inflammation surrounding airways and in alveoli

Question 11

List histological features of lobar pneumonia ?

Answer 11

Widespread fibrinosuppurative consolidation

Question 12

Which tumours tend to arise in the airways ?

Answer 12

Squamous cell carcinomas

Question 13

Which tumours tend to arise in the peripheral alveolar spaces ?

Answer 13

Adenocarcinomas

Question 14

Which tumours tend to arise in the lung pleura ?

Answer 14

Mesothelioma

Question 15

Which tumours tend to arise centrally or peripherally ?

Answer 15

Small cell lung cancer

Question 16

Which lung cancers are more associated with smokers than non-smokers ?

Answer 16

Squamous cell carcinomas and small cell carcinomas

Whereas non-smokers tend to get adenocarcinomas

Question 17

Which mutations are more common in smokers and non-smokers with adenocarcinomas of the lungs?

Answer 17

Smokers - K ras

Non-smokers - EGFR

Question 18

Which has the worse prognosis: small cell lung cancer or non-small cell lung cancers ?

Answer 18

Small cell lung cancers

Question 19

What is hypogammaglobulinaemia ?

Answer 19

An Immune disorder characterised by a reduction in all types of gamma globulins e.g antibodies that form part of the immune response.

Congenital, iatrogenic

SCID, Wiskott-Aldrich syndrome, CLL, nephrotic syndrome

Question 20

Which cancer is associated with asbestos exposure ?

Answer 20

Mesothelioma

Question 21

Which 3 cancers are considered NSCLC

Answer 21

• Adenocarcinoma
• Squamous cell carcinoma
• Large cell carcinoma

Question 22

List 3 congenital causes of bronchiectasis ?

Answer 22

• CF
• Primary colliery dyskinesia
• Hypogammaglobulinaemia
• Yellow nail syndrome

Question 23

List 3 fibrosing causes of interstitial lung disease ?

Answer 23

• Idiopathic pulmonary fibrosis
• Pneumoconiosis
• Radiation pneumonitis

Question 24

List 2 granulomatous causes of interstitial lung disease?

Answer 24

• Sarcoidosis

- extrinsic allergic alveolitis

Question 25

Which part of the lung does asbestosis tend to affect ?

Answer 25

• Lower lobe

Question 26

List 2 examples of extrinsic allergic alveolitis ?

Answer 26

• Farmer’s lung

- Pigeon fancier’s lung

Question 27

List 3 examples of pneumoconiosis ?

Answer 27

• Coal worker’s lung
• Silicosis
• asbestosis

Question 28

How is Extrinsic allergic alveolitis different to pneumoconiosis ?

Answer 28

• Pneumoconiosis is caused by inhalation of mineral dust or inorganic particles leading to fibrosis
• EAA is caused by inhalation of organic antigens which cause an allergic response leading to fibrosis
• EAA has allergic symptoms when exposed to the organic antigen- SOB, fever, chest pain