Pulmonary Pathology

Question 1

What kind of epithelium lines the bronchi?

Answer 1

Ciliated columnar epithelium

Question 2

On a cellular level, acute bronchitis is characterized by ___________.

Answer 2

neutrophils in the airway lumen and epithelial wall

Question 3

Histologically, chronic bronchitis will often show ___________.

Answer 3

mucus gland hypertrophy, squamous metaplasia, and chronic inflammation

Question 4

Bronchiectasis will show _____________.

Answer 4

airways that are dilated in comparison to the pulmonary artery (which frequently runs alongside it)

Question 5

List the four histologic signs of asthma.

Answer 5

Thickened sub-basal lamina; eosinophilic inflammation; mucus hypersecretion; and smooth muscle hyperplasia

Question 6

The smooth muscle layer of the bronchi is usually about as thick as ___________.

Answer 6

the epithelium

Question 7

Chronic bronchiolitis is characterized by ___________.

Answer 7

inflammation of the walls of the bronchioles (mostly lymphocytes)

Question 8

In follicular bronchiolitis, ___________ form.

Answer 8

germinal centers analogous to lymph nodes (mostly B cells with T cells on the periphery)

Question 9

In constrictive and obliterative bronchiolitis, ___________ close the lumen of the bronchiole.

Answer 9

fibrosis and scarring

Question 10

Where does fibrosis and scarring occur in constrictive and obliterative bronchiolitis?

Answer 10

Between the smooth muscle and mucosa

Question 11

Differentiate constrictive and obliterative bronchiolitis.

Answer 11

Obliterative is complete closure; constrictive is partial closure

Question 12

Why is biopsy not indicative of disease severity in obliterative/constrictive bronchiolitis?

Answer 12

Because severity correlates with number of lobes occluded–thus, radiographs and clinical data are needed

Question 13

What cells in what places are typical of acute pneumonia?

Answer 13

Neutrophils in the air spaces

Question 14

__________ cells can arrive in foreign-body aspiration pneumonias.

Answer 14

Multinucleated giant

Question 15

What three things will be in the air spaces in eosinophilic pneumonia?

Answer 15

Eosinophiles, macrophages, and fibrin

Question 16

Organizing pneumonia is also called __________.

Answer 16

BOOP and COP

Question 17

What is DAD?

Answer 17

Diffuse alveolar damage

Question 18

Diffuse alveolar damage is a disorder in which _________ fills the air spaces.

Answer 18

hyaline membranes

Question 19

_______ can get DAD.

Answer 19

Premature infants without surfactant

Question 20

In DAD, the ________ often get thickened.

Answer 20

alveolar septa

Question 21

Enlarged airspaces indicate __________.

Answer 21

emphysema

Question 22

Smoking-related emphysema (like most lung diseases) is worse in the _________.

Answer 22

upper lobes (“smoke rises”)

Question 23

Smoking-related emphysema is worse around ___________, while alpha-1-anti-trypsin emphysema is __________.

Answer 23

the airways; evenly distributed (“panlobular”)

Question 24

In smokers with respiratory bronchiolitis, _________ surround the respiratory bronchiole.

Answer 24

brown-pigmented macrophages

Question 25

Desquamative interstitial pneumonia is a disseminated form of ___________.

Answer 25

respiratory bronchiolitis

Question 26

Pathologists can tell that diffuse alveolar hemorrhage (DAH) happened while the patient was living because ____________.

Answer 26

macrophages will be iron-laden

Question 27

In DAH, alveolar septa may be ____________.

Answer 27

thickened

Question 28

What is PAP? What does it look like on slides?

Answer 28

Pulmonary alveolar proteinosis; pink fluid in air spaces

Question 29

In pulmonary parlance, “interstitial” means __________.

Answer 29

alveolar septa

Question 30

Usual interstitial pneumonia (UIP) is characterized by ___________

Answer 30

patchy heterogeneous fibrosis (that is, a mixture of no fibrosis, moderate fibrosis, and end-stage fibrosis)

Question 31

Honeycombing is _____________.

Answer 31

end-stage fibrosis (in UIP)

Question 32

Honeycombing is usually worst in _________.

Answer 32

the lower lobes

Question 33

Look up the difference between fibroblastic foci and __________.

Answer 33

organizing pneumonia

Question 34

NSIP (_____________) displays a pattern of ____________.

Answer 34

nonspecific interstitial pneumonia; uniform inflammation and fibrosis of septa

Question 35

There will be little ______________ in NSIP.

Answer 35

honeycombing and fibroblastic foci

Question 36

Honeycombing will have ______ in the cysts, while fibrotic NSIP will not.

Answer 36

mucus

Question 37

Hypersensitivity pneumonia (HP) activates in response to __________.

Answer 37

foreign antigen

Question 38

HP centers around __________.

Answer 38

the airways (like smoking-related diseases)

Question 39

Non-necrotizing granulomas also appear in ___________.

Answer 39

hypersensitivity pneumonias

Question 40

Talc particles sometimes show up in ___________.

Answer 40

the pulmonary vessels of IV-drug users

Question 41

What are plexiform lesions?

Answer 41

Endothelial proliferation that replaces the arterial lumen; numerous “slit-like” lesions

Question 42

Sarcoidosis has the same appearance as ____________.

Answer 42

chronic beryllium disease: non-necrotizing granulomas, concentric collagen deposition, and lymphatic distribution

Question 43

Small, blue, easily crushed cells are indicative of ____________.

Answer 43

small-cell carcinoma

Question 44

Small cell carcinomas usually stain positive for ___________.

Answer 44

neuroendocrine markers (chromagranin, synaptophysin, and CD56)

Question 45

Organizing pneumonia will have _________ in the airspaces.

Answer 45

fibroblast plugs

Question 46

Thickened ends of alveolar septa indicate ___________.

Answer 46

broken septa; the recoil will cause enlargement