(P4) Resp. Patho: Chronic congestion of the lung (brown induration)

Question 1

Identify slide :

Define:

Answer 1

Chronic congestion of the lung (brown induration)

-Lung congestion, distention of blood vessels in the lungs and filling of the alveoli with blood as a result of an infection, high blood pressure, or cardiac insufficiencies (i.e., inability of the heart to function adequately).

-Brown induration is fibrosis and hemosiderin pigmentation of the lungs due to long standing pulmonary congestion (chronic passive congestion). Occurs with mitral stenosis and left sided heart failure

Question 2

Define:

Answer 2

Chronic Congestion of the lung (brown induration)

1. air filled space/edematous filled space
   * 2. coat dust**
   * 3. heart failure cells (macrophages phagocytize RBCs)**
2. Hyperemia and fibrosis of septa
3. Chronic LVF
4. Coal dust and hemosiderin in the heart failure cells
5. pulmonary hypertension and right sided heart failure
6. lung is brown and firm (macroscopic appearance)

Question 3

Identify:

Answer 3

Question 4

Identify:

Answer 4

Question 5

identify slide:

Q. What causes this lesion?

Answer 5

Chronic congestion of the lung (brown induration)

Pulmonary congestion is defined as accumulation of fluid in the lungs, resulting in impaired gas exchange and arterial hypoxemia.

Q:Chronic left ventricular failure – impairment of the exit of the blood from the lung

Question 6

Chronic congestion of the lung (brown induration)

Describe the causation of this condition:

Answer 6

SECONDARY W/ LEFT HEART FAILURE

During this congestion-blood fills the alveoli then blood breaks down into hemosiderin-then Macrophages of lung eat the hemosiderin

” Hemosiderin Layden Macrophages” or Heart Failure Cells caused by the L-sided heart failure

(Alveolar septa thickens and cells with brownish pigments = Hemosiderin Layden Macrophages)

Heart failure cells (brown – hemosiderin)

What leads to LHF:

• *1.** Mitral stenosis
• *2.** Hypertrophy of left ventricle (seen in long term hypertension)

3. MI (chronic complications)

Question 7

Identify slide:

What happens in the Alveolar capillaries?

Answer 7

Chronic congestion of the lung (brown induration)

1. Increased pressure in the alveolar capillaries
2. Micro-hemorrhages into the alveoli. Red blood cells are phagocytosed by macrophages (heart failure cells).

(macrophages laden with hemosiderin)

3. Macrophages laden with hemosiderin
4. Fibrosis of the interstitial spaces of the lung
5. Lung is brown and firm – brown induration

Question 8

What is the consequence of this lesion/condition?

Answer 8

Consequence of higher pressure in capillaries is pulmonary hypertension, which may lead to right sided heart failure

Question 9

Describe Microscopy and identify the slide

Answer 9

• Chronic congestion of the lung (brown induration)*
• -Dilated capillaries w/in alveolar wall*
• -Acute → simple hyperemia, interstitial edema*
• -Thickened alveolar septa (fibrosis).*
• -Thickening of the membrane*
• -Fibrosis of septa*

Question 10

Identify:

Answer 10

Chronic congestion of the lung (brown induration)

Question 11

Identify:

Answer 11

Chronic congestion of the lung (brown induration)

Question 12

Identify:

Answer 12

Chronic congestion of the lung (brown induration)

Question 13

Identify

Answer 13

Chronic congestion of the lung (brown induration)

Question 14

• What causes “Chronic LVF”*
• Mechanism*
• and*
• Cells involved during the process*

Answer 14

Chronic LVF

• impairment of the exit of the blood from the lungs Increased pressure in the alveolar capillaries
• Microhemorrhages into the alveoli, red blood cells are phagocytosed by macrophages (heart failure cells) (macrophages laden with hemosiderin)

Question 15

identify slide:

Microscopic appearance:

Consequences of this lesion:

Answer 15

Chronic congestion of the lung (brown induration)

• Fibrosis* of the interstitial spaces of the lung
• Lung is brown and firm* – brown induration

-Consequences of higher pressure in capillaries is pulmonary hypertension, which may lead to right heart failure.