Pathology

Question 1

Schaumann bodies and Asteroid bodies

Answer 1

Laminated dystrophic calcification in sarcoidosis (Schaumann bodies)

Stellate giant cell cytoplasmic inclusions (Asteroid bodies)

Question 2

Mikulicz syndrome

Answer 2

Involvement of the uvea and parotid in Sarcoidosis

Question 3

ACE in Sarcoidosis

Answer 3

Synthesized by endothelial cell’s and macrophages. Elevated in sarcoidosis

Question 4

Honeycomb Fibrosis

Answer 4

In idiopathic pulmonary fibrosis. Refers to dilated cystic spaces lined with Type II pneumocytes, consistent with end stage lung

Question 5

Ferruginous bodies

Answer 5

Asbestos bodies that have become coated with iron in asbestosis

Question 6

Asbestosis exposition

Answer 6

Shipyard work, insulation and construction industries, brake lining manufactures

Question 7

Asbestos types

Answer 7

Serpentine asbestos = curved flexible fibers. Chrysotile the most common

Amphibole asbestos = straight, brittle fibers. Crocidolite, tremolote and amosite the most common. Associated with mesothelioma

Question 8

Pleura involvement in asbestosis

Answer 8

Parietal pleural plaques in a symmetrical distribution (acellular Type I collagen deposition) involving the domes of the diaphragm and posterolateral chest walls on chest x Ray. Plaques on the anterior chest wall may be seen in CT

Question 9

Malignant mesothelioma pathology

Answer 9

Microscopic exam exhibits carcinomatous and sarcomatous elements (biphasic pattern)

Electron microscopy shows long, thin microvilli on some tumor cells

Question 10

Silicosis exposure

Answer 10

Exposure to silicon dioxide (silica)
Sandblaster, metal grinders, miners

Dense modular fibrosis of the upper lobes which may progress to massive fibrosis. Birefringent silica particles can be seen with polarized light

X Ray shows fibrotic nodules in the upper zones of the lungs. Increased risk of TB

Question 11

Berylliosis exposure

Answer 11

Is an allergic granulomatous reaction in the nuclear, electronics and aerospace industries

Type IV hypersensitivity reaction resulting in granulomatous formation (noncaseating granulomas and fibrosis + hiliar lymph node granomas + systemic granulomas in chronic exposure)

Acute exposure causes acute pneumonitis

Question 12

Dietary drugs associated with primary pulmonary hypertension

Answer 12

Fenfluramine and phentermine

Question 13

Genetic mutations in lung cancer

Answer 13

Oncogene MYCL (Small cell carcinoma)
Oncogene KRAS (Adenocarcinoma)
Tumor suppressor genes TP53 and RB1

Question 14

Carney complex

Answer 14

Autosomal dominant (myxomas with endocrine abnormalities and lentigines ir pigmented nevi

Question 15

Carney triad

Answer 15

Pulmonary chondroma (hamartoma with a predominantly cartilaginous component) + extra adrenal paraganglioma + gastric gastrointestinal stromal tumor

Question 16

Lung adenocarcinoma

Answer 16

More commonly in women and NONsmokers
Scar carcinoma (tumor may develop in areas of parenchyma scarring)
PERIPHERAL gray white mass

Atypical adenomatous hyperplasia — adenocarcinoma in situ —

Question 17

Lung squamous cell carcinoma

Answer 17

Related to smoking
Males more than females
Gray white bronchial mass centrally locates
Invasive nests of squamous cells with intercellular bridges (desmosomes) and keratin production (squamous pearls)
Hypercalcemia secondary to PTH like production

Question 18

Lung small cell carcinoma

Answer 18

Related to smoking
Males more than females
Neuroendocrine tumor very aggressive 
ACTH/SIADH
EATON LAMBERT SYNDROME
ACANTHOSIS NIGRICANS
HYPERTROPHIC PULMONARY OSTEOARTHROPATHY

Question 19

Erlotinib

Answer 19

Tyrosine kinase inhibitor which inhibit epidermal growth factor receptor
Used to treat non small cell lung cancer, pancreatic cancer and others