Lung Pathology Flashcards
What composes the upper respiratory tract?
Nose
nasopharynx
larynx
What comprises the lower respiratory tract?
trachea
bronchi
bronchioles
lungs
How do we classify lung disease?
Neoplastic
Non - neoplastic
Describe neoplastic lung disease?
95% tumours are malignant
Majority epithelial in origin
Most arise from bronchus
Lung is a common site fro metastasis
Describe lung cancer presentation?
Usually late as symptoms take a while to show and are often ignored
Associated to smoking
What types of lung cancer occur?
SCC 50%
small cell undifferentiated carcinoma 30%
adenocarcinoma 10%
large cell undifferentiated 10%
How does lung cancer present orally?
epulus / polyp ( looks like gingival swelling)
Describe non neoplastic lung disease?
Lungs have limited ability to respond to insult
Fibrosis dominant
Lugs normally sterile - continuous escalator of mucocilliary clearance
Name 10 types of non neoplastic lung disease?
APPPPCATIW
Acute bronchitis Pneumonia Pulmonary embolus Pulmonary vascular disease Pulmonary oedema COPD Asthma TB Interstitial lung disease Wegners Granulomatosis
What is acute bronchitis?
Mostly cause by a virus - respiratory syncitial virus, H. influenzae and S. pneumoniae
May be associated with laryngitis
Inflammation with retention of secretions - predisposed to secondary infection
What is pneumonia?
Inflammation of the lungs
Classified by causative organism or by anatomy
Where can pneumonia affect the lungs?
LOBAR - limited to lobe
BRONCHOPNEUMONIA - starts in bronchioles and spreads
ASPIRATION - dental instruments
What are the causative organisms for pneumonia?
ACUTE - S. pneumoniae, H. influenzae, S. aureus
OPPORTUNISTIC-gram -ve bacilli, aspergillus, cryptococcus
CHRONIC - TB
What is a pulmonary embolus?
Embolus travel via IVC to right side of heart and into the pulmonary vein and lodges in the pulmonary arterial branch
Mostly caused by thrombotic origin (leg, pelvis)
Cause of sudden death
DVT is secondary to immoblisation
What is pulmonary vascular disease (PVD)?
Disease affecting the blood vessels leading to or from the lungs.
Most common is pulmonary hypertension
PRIMARY - unknown cause: young females, right heart failure and pleural effusion
SECONDARY - hypoxia : COPD, high altitude, congenital heart disease
What is pulmonary oedema?
two causes:
HAEMODYNAMIC (mitral stenosis, left hart failure, nephrotic syndrome) No lung abnormality, imbalance between forces pushing fluid to the alveolar space and forces pulling back into circulation
MICROVASCULAR - septic shock, trauma, burns, pancreatitis, injury to the lung
What is COPD?
Irreversible airway obstruction due to 2 conditions:
BRONCHITIS - abnormal sputum production for 3+ months/yr for 3 yrs. Inflamed bronchioles
EMPHYSEMA - enlarged alveolar spaces distal to terminal bronchiole. Destruction of lunch tissue
What is asthma?
Inflammation, reversible, variable, hyperactivity reaction
Increased airway irritability
Most common cause is allergies (atropy)
Type 1 hypersensitivity - IgE binds to mast cells which become sensitised to specific antigen and then when exposed, mast cells degranulate and release histamine and inflamatory mediators
What is TB?
Most common infective disease in the world
Mycobacterium tuberculosis and bovis
Bacillis infects macrophages and get a cell mediated immune resonse
What is the progression of TB?
Phagocytosis of bacilli by macrophages
TNF alpha release and autocrine stimulation
Cytokine and chemokine release.
Attraction and stimulation of CD4 and CD8 lymphocytes
Increased T cell adhesion
Activated T cells release interferon gamma
Further activation of macrophages
Increased antigen presentation
Intracellular killing of bacilli
Macrophage apoptosis
Granuloma formation
What is interstitial lung disease?
Interstitium is tissue within the septa of the alveoli and tissues surrounding airways and blood vessels
Characterised by fibrosis with decreased lung compliance
What is Wegners Granulomatosis?
Immunological disease affecting the lung and kidneys
Oral manifestations - gingival hyperplasia and URT infection
