Pulmonary Pathology Flashcards
What kind of epithelium lines the bronchi?
Ciliated columnar epithelium
On a cellular level, acute bronchitis is characterized by ___________.
neutrophils in the airway lumen and epithelial wall
Histologically, chronic bronchitis will often show ___________.
mucus gland hypertrophy, squamous metaplasia, and chronic inflammation
Bronchiectasis will show _____________.
airways that are dilated in comparison to the pulmonary artery (which frequently runs alongside it)
List the four histologic signs of asthma.
Thickened sub-basal lamina; eosinophilic inflammation; mucus hypersecretion; and smooth muscle hyperplasia
The smooth muscle layer of the bronchi is usually about as thick as ___________.
the epithelium
Chronic bronchiolitis is characterized by ___________.
inflammation of the walls of the bronchioles (mostly lymphocytes)
In follicular bronchiolitis, ___________ form.
germinal centers analogous to lymph nodes (mostly B cells with T cells on the periphery)
In constrictive and obliterative bronchiolitis, ___________ close the lumen of the bronchiole.
fibrosis and scarring
Where does fibrosis and scarring occur in constrictive and obliterative bronchiolitis?
Between the smooth muscle and mucosa
Differentiate constrictive and obliterative bronchiolitis.
Obliterative is complete closure; constrictive is partial closure
Why is biopsy not indicative of disease severity in obliterative/constrictive bronchiolitis?
Because severity correlates with number of lobes occluded–thus, radiographs and clinical data are needed
What cells in what places are typical of acute pneumonia?
Neutrophils in the air spaces
__________ cells can arrive in foreign-body aspiration pneumonias.
Multinucleated giant
What three things will be in the air spaces in eosinophilic pneumonia?
Eosinophiles, macrophages, and fibrin
Organizing pneumonia is also called __________.
BOOP and COP
What is DAD?
Diffuse alveolar damage
Diffuse alveolar damage is a disorder in which _________ fills the air spaces.
hyaline membranes
_______ can get DAD.
Premature infants without surfactant
In DAD, the ________ often get thickened.
alveolar septa
Enlarged airspaces indicate __________.
emphysema
Smoking-related emphysema (like most lung diseases) is worse in the _________.
upper lobes (“smoke rises”)
Smoking-related emphysema is worse around ___________, while alpha-1-anti-trypsin emphysema is __________.
the airways; evenly distributed (“panlobular”)
In smokers with respiratory bronchiolitis, _________ surround the respiratory bronchiole.
brown-pigmented macrophages
Desquamative interstitial pneumonia is a disseminated form of ___________.
respiratory bronchiolitis
Pathologists can tell that diffuse alveolar hemorrhage (DAH) happened while the patient was living because ____________.
macrophages will be iron-laden
In DAH, alveolar septa may be ____________.
thickened
What is PAP? What does it look like on slides?
Pulmonary alveolar proteinosis; pink fluid in air spaces
In pulmonary parlance, “interstitial” means __________.
alveolar septa
Usual interstitial pneumonia (UIP) is characterized by ___________
patchy heterogeneous fibrosis (that is, a mixture of no fibrosis, moderate fibrosis, and end-stage fibrosis)
Honeycombing is _____________.
end-stage fibrosis (in UIP)
Honeycombing is usually worst in _________.
the lower lobes
Look up the difference between fibroblastic foci and __________.
organizing pneumonia
NSIP (_____________) displays a pattern of ____________.
nonspecific interstitial pneumonia; uniform inflammation and fibrosis of septa
There will be little ______________ in NSIP.
honeycombing and fibroblastic foci
Honeycombing will have ______ in the cysts, while fibrotic NSIP will not.
mucus
Hypersensitivity pneumonia (HP) activates in response to __________.
foreign antigen
HP centers around __________.
the airways (like smoking-related diseases)
Non-necrotizing granulomas also appear in ___________.
hypersensitivity pneumonias
Talc particles sometimes show up in ___________.
the pulmonary vessels of IV-drug users
What are plexiform lesions?
Endothelial proliferation that replaces the arterial lumen; numerous “slit-like” lesions
Sarcoidosis has the same appearance as ____________.
chronic beryllium disease: non-necrotizing granulomas, concentric collagen deposition, and lymphatic distribution
Small, blue, easily crushed cells are indicative of ____________.
small-cell carcinoma
Small cell carcinomas usually stain positive for ___________.
neuroendocrine markers (chromagranin, synaptophysin, and CD56)
Organizing pneumonia will have _________ in the airspaces.
fibroblast plugs
Thickened ends of alveolar septa indicate ___________.
broken septa; the recoil will cause enlargement
