Respiratory histopathology Flashcards

1
Q

what do the letters stand for

A
  • S – serous glands
    V – blood vessels
  • M- mucus secreting goblet cells
  • RE numerous cilia
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2
Q

What covers the external aspect of the nostrils?

A

covered by skin

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3
Q

What type of epithelium lines the vestibule of the nostril?

A

The vestibule of the nostril is initially covered by skin, but then becomes a nonkeratinizing squamous epithelium.

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4
Q

What type of epithelium lines most of the nasal and paranasal sinus cavities?

A

Most of the nasal and paranasal sinus cavities are lined by a pseudostratified columnar epithelium, bearing numerous cilia (RE) (but few patches of squamous epithelium may persist).

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5
Q

What kind of cells are scattered among the columnar cells in the nasal and paranasal sinus cavities?

A

Mucus-secreting (goblet) cells are scattered among the columnar cells in the nasal and paranasal sinus cavities.

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6
Q

What is the respiratory-type epithelium?

A

The respiratory-type epithelium is a ciliated pseudostratified columnar epithelium which lines most of the air-conducting part of the respiratory tract.

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7
Q

What is the function of serous glands in the respiratory tract?

A

The serous glands in the respiratory tract secrete humidifying fluids for inhaled air.

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8
Q

What is the function of mucous glands in the respiratory tract?

A

The mucous glands in the respiratory tract secrete fluids that help trap particulate matter in inhaled air.

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9
Q

What are Clara cells in the respiratory tract?

A

Clara cells are non-ciliated cells found in the epithelium of the respiratory bronchioles and are responsible for producing one of the components of surfactant, having stem cell properties, and detoxifying noxious substances.

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10
Q

What is the structure of an alveolus?

A

Each alveolus consists of a pocket, open at one side, lined by flattened epithelial cells (pneumocytes).

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11
Q

What are alveolar pores?

A

Alveolar pores are small openings (~8μm diameter) in the alveolar septa that allow some movement of air between adjacent alveoli.

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12
Q

label this terminal bronchi

A

A: Alveolus
AS: Alveolar sac
AR: Alveolar ring
AD: Alveolar duct
R: Respiratory bronchiole
T: Terminal bronchiole

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13
Q

What are the two types of pneumocytes that line the alveoli?

A

Type 1 and Type 2.

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14
Q

What percentage of cells do Type 1 pneumocytes represent, and what percentage of surface area do they cover?

A

Type 1 pneumocytes represent about 40% of the cells but 90% of the surface area.

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15
Q

What is the difference in appearance between Type 1 and Type 2 pneumocytes?

A

Type 1 pneumocytes have flattened nuclei, while Type 2 pneumocytes have plump nuclei.

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16
Q

What is the function of Type 2 pneumocytes?

A

Type 2 pneumocytes produce surfactant.

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17
Q

What are the two main types of non-neoplastic respiratory diseases?

A

Obstructive and restrictive lung diseases.

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18
Q

What are some examples of obstructive lung diseases?

A

Asthma, COPD, bronchiectasis, and cystic fibrosis.

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19
Q

What are some examples of restrictive lung diseases?

A

Idiopathic pulmonary fibrosis, scoliosis, and other interstitial lung diseases.

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20
Q

What is COPD?

A

COPD stands for Chronic Obstructive Pulmonary Disease, and is a chronic inflammatory lung disease that obstructs airflow from the lungs.

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21
Q

What are some causes of COPD?

A

Cigarette smoking, dust or irritant exposure.

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22
Q

What are some of the features of the airway in COPD?

A

Chronic inflammation of the airway tubes with bronchial wall thickening, increased mucin accumulation, and persistent productive coughing (chronic bronchitis).

23
Q

What is bronchiectasis?

A

Bronchiectasis is a lung condition where the bronchial tubes become dilated and infected, leading to repeated infections.

24
Q

What is emphysema?

A

Emphysema is a lung condition where the alveolar membranes lose their strength, causing the alveoli to merge and reducing membranous area for exchange of O2 and CO2.

25
Q

What are the histological changes seen in chronic bronchitis?

A

Submucosal infiltration by chronic inflammatory cells (In), hypertrophy of mucosal smooth muscle (M), mucous gland hyperplasia (G), surface epithelium hyperplasia and sometimes squamous metaplasia.

26
Q

What are the histological changes seen in emphysema?

A

Permanent enlargement of the respiratory spaces distal to the terminal bronchioles, accompanied by destruction of their walls.

27
Q

What is the clinical presentation of allergic asthma?

A

Shortness of breath, wheezing and cough due to paroxysmal bronchoconstriction provoked by chemical mediators of immune hypersensitivity reaction (allergy).

28
Q

What are the histological features of allergic asthma?

A

Smooth muscle hypertrophy (M), submucosal gland hyperplasia (G), protracted oedema of submucosa and marked infiltration by eosinophils, and mucus (Mu) obstruction of bronchial lumen.

29
Q

Describe the histological features of pulmonary fibrosis.

A

Pulmonary fibrosis is characterized by thickened alveolar walls due to deposition of collagen, a variable chronic inflammatory infiltrate, and in the late stages, the normal lung parenchyma may be densely fibrotic with macroscopically visible spaces (honeycomb lung). Some cases are associated with exposure to certain drugs, and when no aetiological factors are found, it is called idiopathic pulmonary fibrosis.

30
Q

What are occupational lung diseases?

A

Occupational lung diseases, also known as pneumoconioses, are caused by the inhalation of inorganic dusts and can lead to fibrotic reactions in the lung, ultimately resulting in interstitial lung fibrosis and reduced gas transfer.

31
Q

What is silicosis?

A

Silicosis is the most common occupational lung disease, which occurs in miners and others with industrial exposure to silica dusts. It is characterized by granuloma-like masses formed by macrophages that phagocytose inhaled silica particles, resulting in a focal fibrotic reaction and nodules of collagenous tissue. These nodules contain hyaline (H) and glassy pink acellular material and are more cellular (F) peripherally.

32
Q

How can the presence of silica be demonstrated in silicosis?

A

The presence of silica in silicosis can be demonstrated as refractile particles by polarized light microscopy, as it is not visible with usual histological methods.

33
Q

What is asbestos and how does it cause lung fibrosis?

A

Asbestos is a complex silicate which forms needle-like fibres. Inhaled fibres are coated with proteinaceous material to form segmented asbestos bodies. They elicit a macrophage and giant cell response, leading to fibrosis

34
Q

What neoplastic changes can be caused by exposure to asbestos?

A

Exposure to asbestos predisposes to neoplastic change, including mesotheliomas and an increased risk of lung carcinomas, especially in cigarette smokers. Mesotheliomas may occur many years (>20) after exposure to asbestos.

35
Q

What are some histological features of silicosis?

A

Inhaled silica particles are phagocytosed by macrophages forming granuloma-like masses. These elicit focal fibrotic reaction, forming nodules of collagenous tissue, hyaline glassy pink acellular material centrally and more cellular peripherally.

36
Q

What is the most common type of lung cancer?

A

Adenocarcinoma.

37
Q

What is the histological appearance of small cell carcinoma?

A

Tumour cells appear small, tightly packed, darkly stained and crushed, with nuclear moulding and stippled nuclear chromatin. The tumour shows brisk mitoses and apoptotic activity, and has neuroendocrine differentiation.

38
Q

Which type of lung cancer is most responsive to chemotherapy but has the worst prognosis?

A

Small cell carcinoma

39
Q

What is the histological appearance of squamous cell carcinoma?

A

The tumour is recognisably squamous, forming islands of large, eosinophilic cells with central whorling and with intercellular bridges (desmosomes) between the cells. The bronchial mucosa adjacent to tumours frequently shows evidence of squamous dysplasia.

40
Q

What is the risk factor for squamous cell carcinoma?

A

Cigarette smoking, which can result in squamous metaplasia of the bronchial epithelium.

41
Q

Where do adenocarcinomas tend to arise?

A

Adenocarcinomas tend to arise more peripherally.

42
Q

What is the predilection of adenocarcinomas?

A

Adenocarcinomas have a predilection for old areas of scar tissue.

43
Q

What are the subtypes of adenocarcinoma?

A

The subtypes of adenocarcinoma include non-mucinous and mucinous. Intermediate grade patterns include acinar (shows gland formation) and papillary. High grade patterns include solid and micropapillary, which are associated with a worse prognosis.

44
Q

What are the various architectural patterns seen in adenocarcinomas?

A

Adenocarcinomas show various architectural patterns, and most adenocarcinomas show a mixture of patterns.

45
Q

what is this disease

A

asthma

46
Q

what disease is this

A

chronic bronchitis

46
Q

what disease is this

A

emphysema

47
Q

what disease is this

A

pulmonary fibrosis

48
Q

what disease is this

A

sillicosis

49
Q

what disease is this

A

asbestosis

49
Q

what disease is this

A

small cell carcinoma

50
Q

what disease is this

A

squamous cell carcinoma

51
Q

what disease is this

A

adenocarcinoma