Pleural Pathology Flashcards
This is the excess fluid that accumulates between the 2 pleural layers and can impair breathing by limiting the expansion of the lungs
Pleural effusion
What are the 4 causes of pleural effusions?
- Block lymphatics
- Heart failure
- Greatly reduced colloid pressure
- Infection
What are the 3 types of inflammatory pleural effusions?
serous, serofibrinous, or firinous pleuritis
What are the 5 CAUSES of inflammatory pleural effusions?
TB PNA Lung Infarcts Lung Abscess bronchiectasis
Radiation can often lead to which type of inflammatory pleural effusion?
Serofibrinous pleuritits
What typically causes purulent pleural exudate?
Bacterial or mycotic seeding of the pleural space.
This is the collection of pus within the pleural space.
Empyema
What is the composition of empyema in the pleural space?
Loculated, yellow-gree, creamy pus composed of masses of neutrophils with other leukocytes
Hemorrhagic diseases, rickettsial disease, and neoplastic involvement typically result in what pleural condition?
Hemorrhagic diatheses
This is a collection of serous fluid in the pleural cavity.
Hydrothorax
Are hydrothorax, chylothorax, and hemothorax types of inflammatory or noninflammatory pleural effusion?
Noninflammatory
What is the most common cause of hydrothroax?
Heart failure
What causes hemothorax?
Ruptures aortic aneurysm or vascular trauma
What causes chylothorax?
Typically thoracic duct trauma ir obstruction that causes lymph duct rupture (like malignancy)
This is air or gas in the plaural space.
Pneumothorax
This type of pneumothorax is typically from the rupture of a bleb, resulting in the collapse of the lung.
Spontaneous pneumothorax
Where does the trachea shift in a spontaneous pneumothorax?
Towards the affected lung (Pathoma)
True or False: spontaneous idiopathic pneumothorax usually subsides spontaneously as the air is reabsorbed.
True
This is the type of pneumothorax when theres a defect int eh chest wall that permits entrance of air into the chest cavity but doesnt allow it to escape (like pumping up a basketball).
Tension pneumothorax
Which way does the trachea shift in a tension pneumothorax?
AWAY from the affected lung
Solitary fibrous tumors have what 2 lab values to distinguish it from mesotheliomas?
CD34+
Keratin (-)
This is the type of mesothelioma where there is cuboidal, columnar, or flattened cells forming tubular or papillary structures.
Epitheloid type
This is the type of mesothelioma where its a spindle cell sarcoma.
Sarcomatoid type
What are the Sx for mesothelioma?
recurrent pleural effusions, chest pain, and dyspnea
What % of people die from mesothelioma within 12 months of Dx?
50%
End stage emphysema, idiopathic pulmonary fibrosis, cystic fibrosis, and idiopathic/familial pulmonary arterial hypertension are all candidates for what?
Lung transplant
Why is it easy to get a pulmonary infection in a lung transplant?
The recipient is immunosupressed
What do u see on transbronchial biopsy for acute rejection on lung transplant?
Lymphocytes, plasma cells, and few neutrophils and eosinophils either aroudn small vessels in the submucosa of airways or both.
What is a significant problem in at least 1/2 of all lung transplant pts by 3-5 years?
Chronic rejection
What is the morphology of the lung in chronic rejections?
Bronchiolitis obliterans, the partial or complete occlusion of small airways by fibrosis, with or without active inflammation.
This is the form of pleural effusion where there is high protein, high cholesterol, and high pleural LDH (>0.6 relative to plasma).
Exudate
What is the most common cause of a transudative pleural effusion?
congestive heart failure
What si the most common cause of an exudative pleural effusion?
PNA
This is the turbid or milky white fluid with chylomicrons, and caused by the 5 T’s (thoracic duct trauma, tumor, TB, and Tuberous sclerosis).
Chylous effusion
