Lung Disease Gross Pathology

Question 1

Where can respiratory disease affect? (7)

Answer 1

Nasal cavities, nasopharynx, larynx, trachea, bronchi (extrapulmonary/intrapulmonary), bronchioles, alveoli

Question 2

What are the classes of respiratory diseases (7)

Answer 2

• Congenital anomaly
• Metabolic disturbance
• Circulatory disturbance
• Inflammation
• Degeneration
• Neoplasia

Question 3

What type of disease is this and what is it?

Answer 3

Congenital - Cleft palate (palatoschisis)

Question 4

What type of lesion is this and what is it?

Answer 4

Inflammation

Inflammation of the nasal cavity (rhinitis) - This is a case of Infectious Bovine Rhinotracheitis (IBR), caused by bovine Herpesvirus 1; typically causing a fibrinous-necrotizing inflammation

Question 5

What type of lesion is this and what is it?

Answer 5

Circulatory disturbance - Circulatory disturbance (haemorrhage)

This is an ethmoidal haematoma. This lesion can grossly or endoscopically be mistaken for a tumour

Question 6

What type of lesion is this and what is it?

Answer 6

Atrophy - Atrophy of nasal conchae

This is a case of atrophic rhinitis, caused by Bordetella bronchiseptica and Pasteurella multocida; characterized by inflammation and atrophy of nasal conchae (turbinates)This is a case of atrophic rhinitis, caused by Bordetella bronchiseptica and Pasteurella multocida; characterized by inflammation and atrophy of nasal conchae (turbinates)

Question 7

Define aplasia

Answer 7

•Lack of development of an organ

Question 8

Define hypoplasia

Answer 8

•Incomplete development of an organ

Question 9

Define hypertrophy

Answer 9

Increased size of cells

Question 10

Define hyperplasia

Answer 10

•Increased number of cells

Question 11

Define atrophy

Answer 11

Reduced number/size of cells

Question 12

Define neoplasia

Answer 12

•Abnormal growth of cells

Question 13

What type of anomaly is this?

Answer 13

Congenital anomaly

This picture shows everted laryngeal saccules, a feature of the brachycephalic airway syndrome. Other features include stenotic nostrils and nasal meatuses and an excessively long soft palate

Question 14

What lesion is this?

Answer 14

Tracheitis

This is another case of Infectious Bovine Rhinotracheitis (IBR), caused by bovine Herpesvirus 1;
Tracheitis = inflammation of the trachea

Question 15

What lesion is this?

Answer 15

Circulatory disturbance - The lungs are distended by oedema fluid, resulting in rounded edges and oedematous distention of the interlobular septa. The marked reddening is due to vascular congestion

Question 16

What is this?

Answer 16

Pulmonary oedema -

Air (trachea) + fluid (lung) = Foam

Question 17

What type of lesion is this?

Answer 17

Inflammation

Bronchopneumonia

This is a case of bovine enzootic pneumonia (calf pneumonia), characterized by a cranioventral suppurative bronchopneumonia
(= inflammation of bronchi and lung);
Cause: primarily viral (PI-3 virus, BRSV…), secondarily bacterial (Pasteurella multocida, Mannheimia haemolytica…)

Question 18

What are the portals of entry into the lung (3)

Answer 18

•Erogenous (inhalation)

• Infectious agents, toxic gases

•Haematogenous (blood)

• Infectious agents, toxins

•Direct extension

• Penetrating wounds, migrating awns, bites, oesophagus rupture, diaphragm perforation (hardware)

Question 19

What type of lesion is this?

Answer 19

Interstitial pneumonia - The inflammation takes place primarily in the alveolar walls and the contiguous bronchiolar interstitium; gross: failure to collapse, diffuse (!) distention, occasional rib impressions (poor deflation); port of entry can be haematogenous or erogenous

Question 20

What is this?

Answer 20

Interstitial pneumonia

Question 21

What type of lesion is this?

Answer 21

Metastatic neoplasia

This was a case of metastatic sarcoma (not further classified)

Question 22

What parasite is this?

Answer 22

Dictyocaulus viviparus

Note the large amount of foam in the tracheal lumen
→ evidence of pulmonary oedema!

Question 23

What is happening here?

Answer 23

Alveolar pattern

Question 24

What is the treatment for IDIOPATHIC PULMONARY FIBROSIS (IPF) (7)

Answer 24

• Symptomatic treatment
  
  • Avoid trauma to airway i.e. collars, harness only, avoid smoke inhalation
• Inhaled therapy
  
  • Bronchodilator only if secondary airway spasm, corticosteroids
• Oral therapy
  
  • Bronchodilators - especially if concurrent airway collapse
  • Corticosteroids
    
    • Can make animals pant more so ?
• Additional immunosuppressive medication
  
  • Azathioprine and cyclosporin
  • No evidence of clinical efficacy
• Antibiotics as necessary
  
  • Airways not sterile, they can get recurrent infection
• Anti-fibrotics (e.g. colchicine)
  
  • Theoretically slows collagen deposition and reduces production of profibrotic cytokines
  • No evidence for efficacy of these in veterinary patients
  • No evidence of improved outcomes in humans either
• Management of pulmonary hypertension (it is a secondary complication of this, so improve this, then right sided compliance and the hearts ability to get blood into lungs may improve)
  
  • Phosphodiesterase inhibitors
    
    • Sidenafil, tadalafil
    • pimonbendan

Question 25

What is going on?

Answer 25

Cranial mediastinum: can see the margin between the two lung lobes.

Air bronchograms seen

Right middle lung lobe consolidation
There is a marked alveolar pattern overlying the heart with visible air bronchograms. This is the right middle lung lobe which can be affected by pneumonia including secondary to aspiration.