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MODHIII - Unit 3 > Pulmonary Pathology > Flashcards

Pulmonary Pathology Flashcards

1
Q

Anatomic patterns of pneumonia

A
  • patchy: bronchopneumonia

- whole lobe: lobar pneumonia

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2
Q

Pathologic stages of bacterial pneumonia

A
  • congestion
  • red hepatization
  • gray hepatization
  • resolution
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3
Q

Congestion stage of bacterial pneumonia

A
  • gross lung: heavy, boggy, red

- microscopic: vascular engorgement, intra-alveolar fluid, FEW neutrophils, numerous bacteria

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4
Q

Red hepatization stage of bacterial pneumonia

A
  • gross lung: red, firm, airless, liver-like consistency

- microscopic: exudate composed of neutrophils, red cells, and fibrin; filling alveolar spaces

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5
Q

Gray hepatization stage of bacterial pneumonia

A
  • gross lung: grayish brown, dry surface

- microscopic: disintegration of red blood cells, persistence of fibropurulent exudate

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6
Q

Resolution stage of bacterial pneumonia

A
  • microscopic: enzymatic digestion of alveolar exudate to produce granular, semifluid debris that gets resorbed, ingested by macrophages, expectorated or organized by fibroblasts growing into it
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7
Q

Complications of pneumonia paired with pathologic process

A
  • destruction and necrosis w/ accumulation of neutrophils–abscess
  • spread of infection to pleural cavity–empyema (intrapleural fibrinosuppurative reaction)
  • spread of infection via blood vessels–bacteremic dissemination (heart valves, brain, kidney)
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8
Q

Best example of microorganism for bacterial pneumonia

A

streptococcus pneumonia

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9
Q

Best example of atypical bacterial pneumonia

A

mycoplasma pneumonia

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10
Q

Viral/atypical bacterial pneumonia pathology

A
  • infection that leads to inflammation of interstitium

- inflammatory infilitrate compose of LYMPHOCYTES, histiocytes, plasma cells

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11
Q

Viral pneumonia causes

A
  • influenza A and B
  • respiratory syncytial virus (RSV)
  • human metapneumovirus
  • adenovirus
  • rhinovirus, rubeola, varicella
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12
Q

Different histologic findings in pneumonia: bacterial vs. viral

A

Bacterial: located in alveolar spaces, neutrophils
Viral: located in interstitium, lymphocytes

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13
Q

Histologic features of usual interstitial pneumonia

A
  • hetergeneity of interstitial fibrosis
  • fibroblastic foci
  • honeycomb fibrosis
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14
Q

Histologic features of hypersensitivity pneumonitis

A
  • poorly formed granulomas: non caseating
  • interstitial pneumonitis consisting of lymphocytes, plasma cells, macrophages
  • interstitial fibrosis and honeycombing (late stage)
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15
Q

Key association with hypersensitivity pneumonitits

A

BIRDS ARE BAD

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16
Q

Gross lung appearance in sarcoidosis

A
  • multiple small white nodules many next to airways
17
Q

Histologic features of Sarcoidosis

A
  • non caseating granulomas
  • asteroid body
  • schaumann body
18
Q

Location of non necrotizing granulomas in sarcoidosis

A
  • beneath pleura
  • along interlobular septa
  • bronchovascular bundles
19
Q

Three most common lung carcinomas

A
  • non small cell carcinoma: adenocarcinoma, squamous cell carcinoma
  • small cell carcinoma
20
Q

Male to female ratios of lung carcinoma

A
  • adenocarcinoma: males 37%, females 47%
  • squamous cell carcinoma: males 32%, females 25%
  • small cell carcinoma: males 14%, females 18%
21
Q

5 year survival rate of lung carcinomas

A
  • non small cell carcinoma: 21.4%

- small cell carcinoma: 6.5%

22
Q

Metastatic carcinoma differences

A
  • more common than primary lung cancer
  • most commonly presents as multiple bilateral nodules (vs. primary lung cancer that usually presents as a solitary lesion)
23
Q

Squamous cell carcinoma location and histologic findings

A
  • location: centrally in the mainstem, lobar or segmental bronchi
  • features: keratinization (eosinophilic dense cytoplasm), pearl formation, intercellular bridges
24
Q

Small cell carcinoma location and histologic findings

A
  • location: central or peripheral

- small cells, scant cytoplasm, granular nuclear chromatin (salt and pepper pattern), high mitotic rate, nuclear molding

25
Q

Lung carcinomas arising from neuroendocrine cells

A
  • small cell carcinoma

- carcinoid

26
Q

Carcinoid carcinoma

A
  • low grade malignant epithelial neoplasms
  • based on number of mitosis and/or presence of necrosis divided into: typical and atypical
  • good 5 year survival: typical-87%, atypical-56%
  • NOT PRECURSORS OF SMALL CELL CARCINOMA*
27
Q

5 year survival of small cell carcinoma: why

A
  • 6.5%

- very aggressive behavior

28
Q

Carcinomas associated with smoking

A
  • small cell carcinoma

- squamous cell carcinoma

29
Q

Mutation seen commonly with adenocarcinoma

A
  • EGFR mutation
30
Q

Adenocarcinoma location and histologic features

A
  • location: peripheral

- features: gland formation, mucin production

31
Q

Bronchioloalveolar carcinoma

A
  • old name for non invasive adenocarcinoma

- not in new WHO classification

32
Q

Mesothelioma

A
  • rare tumor of PLEURA (not parenchyma)
  • asbestos exposure is cause
  • very pore outcome
33
Q

Bronchioloalveolar carcinoma (BAC) histologic features and subtypes

A
  • grow along intact alveolar walls
  • no invasion
  • subtypes: mucinous, non mucinous
34
Q

Name for growth pattern in bronchioloaveolar carcinoma

A

lepidic

35
Q

Mesothelioma stats

A
  • rare malignant tumor of mesothelial origin
  • 90% asbestos related
  • latent period 20-45 years
36
Q

Key histologic feature of asbestos exposure

A
  • asbestos body: asbestos fiber coated w/ iron protein complex, found in lung tissue
37
Q

Histologic findings of bacterial pneumonia

A
  • intra-alveolar exudate: fibrin, neutrophils

- congestion of alveolar capillaries

MODHIII - Unit 3 (20 decks)

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