Histopathology: Lung Pathology Flashcards
Infant presenting with respiratory failure. Bowel loops and the liver can pass into the thorax and compress the developing lung, causing hypoplasia of the lung. What is this condition?
Congenital diaphragmatic hernia
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Respiratory tract infection
A lung mass composed of terminal bronchioles. There are no normal alveoli. What is this condition?
Congenital (Cystic) Adenomatoid Malformation
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A discrete mass of lung tissue that has no normal connection with the respiratory tract. What is this condition?
Pulmonary sequestration
Arterial pO2 <8kPa. What is this condition?
Respiratory Failure
Presents as shortness of breath. Caused by severe pneumonia, pulmonary embolism, acute asthma, pulmonary fibrosis. Caused by ventilation/perfusion mismatching (Increased ventilation removes excess CO2). What is this condition?
Type 1 respiratory failure
Caused by COPD, neuromuscular disorders impairing ventilation. Generalized alveolar hypoventilation (Both O2 and CO2 transfer Impaired). What is this condition?
Type 2 respiratory failure
A very severe form of acute lung injury defined as a ratio of PaO2:FiO2 <200mmHg in the presence of bilateral alveolar infiltrates on chest X-ray and in the absence of left ventricular failure. What condition is this?
Acute respiratory distress syndrome
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PaO2/FiO2 ratio is the ratio of arterial oxygen partial pressure to fractional inspired oxygen
Histopathology: diffuse alveolar damage characterized by the presence of hyaline membranes lining alveolar spaces. Hyaline membranes are composed of a mixture of fibrin and necrotic alveolar epithelial cells. Most likley diagnosis?
Acute respiratory distress syndrome
Persistent productive cough and haemoptysis. Histopathology: Bronchial dilation with marked chronic inflammation in the wall, often with lymphoid aggregates and germinal centres. Adjacent alveoli may show an acute and organizing pneumonia. Most likely diagnosis?
Bronchiectasis
An abnormal permanent dilation of bronchi accompanied by inflammation in their walls and in adjacent lung parenchyma. What is this condition?
Bronchiectasis
An inherited disorder caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Lack of normal CFTR causes a defective electrolyte transfer across epithelial cell membranes, resulting in thick mucus secretions.
What is this condition?
Cystic Fibrosis
Most patients present with pulmonary disease due to recurrent infections. Initially, common bacteria colonize the lungs, but eventually Pseudomonas aeruginosa often becomes the dominant organism. Pancreatic insufficiency is also common. Bowel obstruction may occur in the neonatal period due to thick meconium (meconium ileus) or develop later in childhood. Liver disease develops late. Some cases may be diagnosed when a raised serum immunoreactive trypsin is picked up on neonatal screening. What is this condition?
Cystic Fibrosis
Shortness of Breath, sudden onset. Histopath: Leisions composed of a mixture of fibrin and enmeshed blood cells, often arranged in alternating linear bands that correspond to the macroscopic lines of Zahn. What is this condition?
Pulmonary embolism
A mean pulmonary artery pressure >25mmHg at rest or >30mmHg during exercise. What is this condition?
Pulmonary Hypertension
Presents with exertional dyspnoea and fatigue. Dizziness and syncope are also common. May be idiopathic or associated with certain drugs, HIV infection, collagen vascular disease, and congenital systemic-to-pulmonary shunts. What is this condition?
Pulmonary Hypertension
Histopatholoy: All cases show muscular hypertrophy and intimal proliferation of small pulmonary arteries and muscularization of pulmonary arterioles.
- Severe cases show plexiform lesions, characterized by a proliferation of slit-like vascular spaces from the arterial wall.
- Very severe cases may display fibrinoid necrosis of the arterial wall.
Pulmonary hypertension
A chronic inflammatory disorder of large airways characterized by recurrent episodes of reversible airway narrowing. What is this condition?
Asthma
Intermittent episodes of breathlessness, wheeze, and chest tightness. Cough, particularly at night, is also common.
Histopathology: Airways show evidence of inflammatory activity with eosinophils which are not usually seen in normal airways. There may also be basement membrane thickening, goblet cell hyperplasia, and prominent smooth muscle.
Most likely diagnosis?
Asthma
A chronic lung condition characterized by breathlessness due to poorly reversible and progressive airflow obstruction. What is this condition?
Chronic Obstruxtive Pulmonary Disorder
Sudden onset of exertional breathlessness on a background of prolonged cough and sputum production. Spirometry typically shows a low FEV1 and low FEV1/FVC ratio. The lungs are hyperinflated with thick mucus in the airways and dilated terminal airspaces. Bullae may be present. Most likely diagnosis?
COPD
Histopathology: Chronic inflammation and fibrosis of small bronchioles (chronic obstructive bronchiolitis). Finely pigmented macrophages in respiratory bronchioles (respiratory bronchiolitis). Dilated terminal airspaces (emphysema). Larger airways may show mucus gland hyperplasia.
COPD
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- Chronic inflammation and fibrosis of small bronchioles (chronic obstructive bronchiolitis).
- Finely pigmented macrophages in respiratory bronchioles (respiratory bronchiolitis).
- Dilated terminal airspaces (emphysema).
Four main patterns of pneumonia. What are they?
Bronchopneumonia
Lobar pneumonia
Abscess formation
Granulomatous inflammation
