Pulmo Pathology Flashcards
Centriacinar emphysema
Increased size lung fields
Hypertranslucency (vascular destruction
Long thin heart - emphysema
No infiltrates
Centriacinar emphysema
extensive involvement of upper lung field
Centriacinar emphysema
Destroyed respiratory bronchioles and alveolar ducts distal to the terminal bronchiole
Note that the alveoli (i.e.,
peripheral portion of the lung acinus) are comparatively intact.
Bronchiole in the centre (no cartilage)
Dilated + mucostasis
Peribronchial chronic inflammation composed of mature lymphocytes (small airways disease)
Hyperinflated lung fields w/o infiltrates
Patchy areas of atelectasis (right lower zone on PA film)
Hyperinflated lungs (don’t collapse even after removed)
Mucous plug
Membranous bronchiole and accompanying pulmonary artery
Mucou secretions within airway lumen
airway inflammation/thickening
Mucu within airway lumen
Apparent thickening of the subepithelial basement membrane
Inflammatory infiltrates (PMNs + eosinophils)
Subepithelial and adventitial fibrosis
Extensive bronchiectasis
Bronchiectasis
pneumonia + abscess formation
Bronchiectasis
Mucous secretions within airway lumen
Chronic airway inflammation
Some goblet cell metaplasia of the epithelium
Dilated submucosal glands
Inspissated secretions within their lumens (typical of CF)
Consolidation of R. middle lobe
Consolidation of whole R middle lobe (uniform)
Grayish brown dry surface
Lobar pneumonia
Suppurative, neutrophil-rich exudate filling alveolar air spaces
+ Hx (foul purulent sputum, chills, fever)
Lung abscess
Cavitatory lesion with irregular walls
Necrosis of lung tissue
Lung abscess
Well-circumsized 3-4 cm lesion with necrotic material in the centre
The cavity contains necrotic sloughed lung tissue and
degenerated purulent excudate in varied proportions
The cavity is surrounded by granulation tissue which in long-standing
cases, will become a well-developed fibrous capsule
Lung abscess
suppurative
destruction of the lung parenchyma within the central area of cavitation
The cavity contains necrotic sloughed lung tissue and
degenerated purulent excudate in varied proportions
The cavity is surrounded by granulation tissue which in long-standing
cases, will become a well-developed fibrous capsule (which is seen in the photograph).
ARDS, severe pneumonia
early exudative phase of ARDS with edema, cellular debris and early hyaline membrane formation
proliferative phase of ARDS
well defined hyaline membranes
increased cellularity in the interstitium with occasional
fibroblast-like cells seen (spindled cells)
arrow = hyaline membranes
Ground glass centrilobular nodes
Extrinsic allergic alveolitis (hypersensitivity pneumonitis)
Irregular chronic interstitial inflammatory infiltrate
Poorly formed granulomas and chronic interstitial inflammation at
arrows, no true fibrosis
Extrinsic allergic alveolitis (hypersensitivity pneumonitis)
Granulomas are present in lung and mediastinal node; node is enlarged because it is completely replaced by granulomas.
Dx = sarcoid
Granulomas are present in lung and mediastinal node; node is enlarged because it is completely replaced by granulomas.
Dx = sarcoid.
Granulomas are present in lung and mediastinal node; node is enlarged because it is completely replaced by granulomas.
Dx = sarcoid
Patchy patterns of fibrosis
Fibroblast focus at arrow
Usual interstitial pneumonia (idiopathic pulmonary fibrosis)
R. lower lobe collapse
Atelectasis due to obstruction or compression
Bronchial biopsy
Moderately well-differentiated squamous cell carcinoma
Upper 10% of photograph = bronchial mucosa
immediately below: chronic inflammatory cells, including many plasma cells
Squamous cell carcinoma
single cell keratinization
Squamous cell carcinoma
keratin pearl formation
Squamous cell carcinoma
intercellular bridges
Adenocarcinoma
gland formation
Adenocarcinoma
mucus production
Cavitary Pancoast tumour
cavity inside lesion = carcinoma, TB, lung abscess
Sputum cytology and fine needle aspiration of supraclavicular mass
Small cell carcinoma
In sputum the tumor appears as small dark cells in non-cohesive clusters; nuclei are hyperchromatic, nucleoli are absent, cytoplasm is scant, nuclei mold around one another and crush artefact may be present.
Well preserved small cell carcinoma cells in fine needle aspirates are two to three times the size of a lymphocyte, have “salt
and pepper” chromatin with hyperchromatic, variably sized and shaped nuclei, no (or inconspicuous) nucleoli and tend to mold
around one another.
Crush artifact (strands of DNA) is usually present. The tumor cells tend to be clustered together but are not usually cohesive
Cardiac muscle showing small cell carcinoma infiltration (uncommon)
