Lung Pathology IV Flashcards
desquamative interstitial pneumonia
lots of smokers macrophages in alveoli
NOT desquamative
> 50yo
Male
Tx - steroids and cessation of smoking
respiratory bronchiolitis associated interstitial lung disease
pigmented macrophages in bronchioles
-peribronchiolar fibrosis
30+ pack year history
Tx - stop smoking
**not as bad as macros in alveoli
pulmonary langerhans cell histiocytosis
eosinophilic granuloma
proliferating dendritic cells
-response to smoking
Tx - stop smoking
express CD1a, S-100, CD207
CD1a
seen in pulmonary langerhans cell histiocytosis
pulmonary alveolar proteinosis
cough and gelatinous chunky sputum
bilateral, patchy CXR
accumulation of acellular surfactatnt in intra-alveolar and bronchiolar spaces
autoimmune
secondary
congenital - fatal
Tx - pulmonary lavage and GM-CSF therapy or transplant
accumulation of acellular surfactant in intraalveolar bronchiolar spaces
pulmonary alveolar proteinosis
ABC3 gene mutation
pulmonary alveolar proteinosis
pulmonary embolism
SOB, chest pain, swollen leg
saddle embolus
massive PE - death
- massive stress on right heart
- right side HF
PEA
fever, chest pain, SOB, electromechanical dissociation, sudden death
pulmonary embolism
mismatch of V/Q
pulmonary embolus
gold standard for PE
angiography
other emboli
fat - has vacuoles
amniotic fluid - blue lines
air - iatrogenic
nitrogen - divers
amniotic fluid emboli
during delivery
- can lead to DIC
- many patients die
Fen/Phen
interstitial fibrosis of lung
led to pulmonary HTN
bush tea
backyard tea
can lead to pulmonary HTN
primary pulmonary arterial HTN
80% genetic
idiopathic
mostly females 20-40yo
autosomal dominant
BMPR2 mutation
idiopathic primary pulmonary arterial HTN
BMPR2 - inhibits proliferation of vascular smooth m
secondary pulmonary HTN
normal rxn of arteries to increased pressure
medial hypertrophy
narrows arteries
-further increase P
lead to cor pulmonale
atheromas
form with pulmonary HTN
plexiform
severe long standing pulmonary HTN leads to oblitered lumen and revascularization**
diffuse alveolar hemorrhage syndrome
causes
- goodpastures
- idiopathic pulmonary hemosiderosis
- vasculitis
hemosiderin laden macrophages
alpha3 chain of collagen IV
anti-BM membrane antibodies
-goodpasture syndrome
proliferative rapidly progressive GN and necrotizing hemorrhagic interstitial pneumonitis
goodpasture
goodpasture
M young smokers teens-20yo
pulmonary and renal symptoms
Tx - immunosuppression and plasmapharesis
SOB, proteinuria, hematuria, elevated Cr, couging up blood, hemoptysis
goodpasture
linear anti-BM deposits
lung and kidney
goodpasture
idiopathic pulmonary hemosiderosis
rare, children
diffuse hemorrhage
hemosiderin deposition in macrophages and alveolar walls
Tx immunosuppression
bloody cough, weight loss, anemic
cANCA
PR3
wegeners
wegener granulomatosis
necrotizing granulomatous arteritis of lungs
wegeners
upper resp lesions, vasculitis with granulomas, kidney problems
triad for wegeners
pulmonary infectious disease
often viral
splenectomy pts
lose ability to mount response to encapsulated pneumococcus**
COPD pneumonia
haem influenza
gram - pleomorphic
gram - pleomorphic
haem influenza
COPD pneumonia
splenectomy/sickle cell pneumonia
streptococcus pneumonia
gram + diplococci
post viral pneumonia
staph aureus
gram + cocci
cystic fibrosis pneumonia
pseudomonas aeruginosa
gram - coccobacilli
gram + diplococci
streptococcus pneumonia
splenectomy/sickle cell
gram + cocci
staph aureus
post viral pneumonia
legionella
macrophage response - not neutrophils
debilitaed/malnourished pneumonia
klebsiella pneumoniae
gram - rod
cold agglutinins
mycoplasma pneumoniae
atypical pneumonias
chlamydia
viruses
mycoplasma
coxiella
