Pulmonary Pathology I

Question 1

Describe the differences between acute and chronic bronchitis on a histology slide

Answer 1

• Acute Bronchitis
  
  • Airway is filled with neutrophils
    
    • Recall: neutrophils are multilobar and have a fair amount of cytoplasm between them
• Chronic Bronchitis
  
  • Airway is filled with lymphocytes
    
    • Recall lymphocytes stain dark purple and hardly any cytoplasm
  • Normal cilliary columnar epithelium -> squamous metaplasia
  • Mucous hyperplasia

Question 2

What is a histological feature of bronchiectasis?

Answer 2

• Airway is dilated compared to the artery next to it
  
  • Normally the artery is bigger or equal to airway

Question 3

What are the 4 histological features of Asthma?

Answer 3

1. Thickened subbasal lamina - see attached
2. Eosinophilic inflammation
3. Mucus hypersecretion
4. Smooth muscle Hyperplasia

Question 4

What is the histologic feature of Chronic Bronchiolitis?

Answer 4

• Chronic inflammation in the wall of the bronchiole
  
  • Mostly lymphocyte invasion
• Recall: Bronchioles have no cartilage in the airway

Question 5

What is the main histologic feature of Constrictive/Obliterative bronchiolitis

Answer 5

• Inflammation & fibrosis between the mucosa and the smooth muscle squeezing the lumen closed.

Question 6

What is the main histologic feature of Granulomatous bronchiolitis?

Answer 6

1. Histiocytes & multinucleated giant cells
   
   • May be necrotizing or nonnecrotizing

Question 7

What is the characteristic histologic finding of acute pneumonia?

Answer 7

• Neutrophils filling airspaces (not airway)

Question 8

What is the histologic finding of aspiration pneumonia?

Answer 8

• Foereign material in airspaces (food)
• May also have multinucleated giant cells

Question 9

What is the histologic finding in eosinophilic pneumonia

*Hint - the name includes one major finding

Answer 9

• Eosinophils
• Macrophages
• Fibrin in airspaces (pink gritty material)

Question 10

What are the histologic findings in organizing pneumonia?

Answer 10

1. Fibroblast plugs in airways and airspaces
2. Patchy but may be densely consolidating
3. May also include small amounts of [pink] fibrin

Question 11

What is the histologic finding in diffuse alveolar damage?

Answer 11

• Hyaline membranes (pink ribbons of fibrin) filling airspaces
• Alveolar septa thickened by inflammation and fibrolastic tissue

Question 12

What are the histologic findings in emphysema?

Answer 12

• Enlarged airpsaces
• Broken alveolar septa
• Subpleural blebs

Question 13

T/F: Smoking related emphysema is the same everywhere (panlobular) ?

Answer 13

False

• Smoking related emphysema is worse around the airways (centrilobular)

Question 14

T/F: Alpha-1-antitrypsin deficiency associated emphysema is worse around the airways (centrilobular)?

Answer 14

False

• Alpha-1-antitrypsin associated emphysema is the same throughout the lobule (panlobular)

Question 15

What is a characteristic histologic finding of respiratory bronchiolitis?

Answer 15

• Pigmented macrophages in airspaces near bronchioles