Difference between revisions of "Medical lung diseases"

Jump to navigation Jump to search

Medical lung diseases (view source)

Revision as of 14:54, 23 March 2017

8,273 bytes removed ,  14:54, 23 March 2017
→‎Smoking associated disease
 
(13 intermediate revisions by the same user not shown)
Line 57: Line 57:


==Bronchiectasis==
==Bronchiectasis==
===General===
{{Main|Bronchiectasis}}
*Benign.
*Uncommon.
*Predisposes for infection.<ref name=Ref_PBoD8_693>{{Ref PBoD8|693}}</ref>
**Usually a mixed flora.
**May be predominantly fungal, e.g. ''allergic bronchopulmonary [[aspergillosis]] (ABPA)''.
*Multitude of causes - including:
**[[Cystic fibrosis]] - typically diffusely involvement, unlike other causes.<ref>URL: [http://library.med.utah.edu/WebPath/LUNGHTML/LUNG053.html http://library.med.utah.edu/WebPath/LUNGHTML/LUNG053.html]. Accessed on: 21 February 2012.</ref>
**[[Primary ciliary dyskinesia]].
 
===Gross===
*Large airways at the periphery of the lung.
*Central airways larger than the adjacent arteries.
*Typically focal.
 
Radiologic:
*Central airways larger than the adjacent arteries.
*Airway wall-thickening.<ref>{{Cite journal  | last1 = Stockley | first1 = RA. | title = Commentary: bronchiectasis and inflammatory bowel disease. | journal = Thorax | volume = 53 | issue = 6 | pages = 526-7 | month = Jun | year = 1998 | doi =  | PMID = 9713456 }}</ref>
*"Tree-in-bud" abnormalities.
 
====Images====
<gallery>
Image:Bronchiectasis.jpg | Bronchiectasis. (WC)
</gallery>
www:
*[http://library.med.utah.edu/WebPath/LUNGHTML/LUNG053.html Bronchiectasis (utah.edu)].
 
===Microscopic===
Features:
*Dilated airways.
**Airways larger than arteries.
 
====Image====
www:
*[http://library.med.utah.edu/WebPath/LUNGHTML/LUNG054.html Bronchiectasis (utah.edu)].


==Pulmonary hemorrhage==
==Pulmonary hemorrhage==
Line 98: Line 64:
==Constrictive bronchiolitis==  
==Constrictive bronchiolitis==  
*[[AKA]] ''bronchiolitis obliterans'', [[AKA]] ''obliterative broncholitis'',<ref name=pmid16493150/> [[AKA]] bronchiolitis obliterans syndrome (BOS).<ref name=pmid18707652>{{Cite journal  | last1 = Sato | first1 = M. | last2 = Keshavjee | first2 = S. | title = Bronchiolitis obliterans syndrome: alloimmune-dependent and -independent injury with aberrant tissue remodeling. | journal = Semin Thorac Cardiovasc Surg | volume = 20 | issue = 2 | pages = 173-82 | month =  | year = 2008 | doi = 10.1053/j.semtcvs.2008.05.002 | PMID = 18707652 }}</ref>
*[[AKA]] ''bronchiolitis obliterans'', [[AKA]] ''obliterative broncholitis'',<ref name=pmid16493150/> [[AKA]] bronchiolitis obliterans syndrome (BOS).<ref name=pmid18707652>{{Cite journal  | last1 = Sato | first1 = M. | last2 = Keshavjee | first2 = S. | title = Bronchiolitis obliterans syndrome: alloimmune-dependent and -independent injury with aberrant tissue remodeling. | journal = Semin Thorac Cardiovasc Surg | volume = 20 | issue = 2 | pages = 173-82 | month =  | year = 2008 | doi = 10.1053/j.semtcvs.2008.05.002 | PMID = 18707652 }}</ref>
===General===
{{Main|Constrictive bronchiolitis}}
*'''''Not''''' the same as (idiopathic) ''[[bronchiolitis obliterans organizing pneumonia]] (BOOP)'' - in short:
**BOOP: clogs the airway, has Masson bodies, treated with steroids - good prognosis.
**Constrictive bronchiolitis: fibrosis around airways, crappy prognosis.
 
*No good treatment.
*Progressive.
 
Etiology/associations:<ref name=pmid16493150/>
*Post-infectious.
**Viral, e.g. [[Adenovirus]].
**Mycoplasma.
*Post-lung transplant.<ref name=pmid19896545/>
*Post-hematopoietic stem cell transplantation
**Associated with GVHD.<ref name=pmid19896545>{{Cite journal  | last1 = Chien | first1 = JW. | last2 = Duncan | first2 = S. | last3 = Williams | first3 = KM. | last4 = Pavletic | first4 = SZ. | title = Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease. | journal = Biol Blood Marrow Transplant | volume = 16 | issue = 1 Suppl | pages = S106-14 | month = Jan | year = 2010 | doi = 10.1016/j.bbmt.2009.11.002 | PMID = 19896545 }}</ref>
*Connective tissue disease, mostly [[rheumatoid arthritis]].
*[[Ulcerative colitis]].
*Drugs - penicillamine.
*Toxins.
*Idiopathic.
 
===Microscopic===
Features:<ref name=pmid16493150>{{Cite journal  | last1 = Visscher | first1 = DW. | last2 = Myers | first2 = JL. | title = Bronchiolitis: the pathologist's perspective. | journal = Proc Am Thorac Soc | volume = 3 | issue = 1 | pages = 41-7 | month =  | year = 2006 | doi = 10.1513/pats.200512-124JH | PMID = 16493150 | url = http://pats.atsjournals.org/cgi/content/full/3/1/41 }}</ref>
#Bronchiolitis - mononuclear and neutrophilic.
#*May be minimal late in the disease.
#Fibrosis - submucosal and peribronchiolar.
#*Can be patchy.
 
Notes:
*Bronchioles = noncartilagenous airways usu. < 2 mm in diameter.<ref name=pmid16493150/>
 
Images:
*[http://pats.atsjournals.org/cgi/content/full/3/1/41/FIG4 Constrictive bronchiolitis (atsjournals.org)].
 
===Stains===
*Elastic trichrome - useful for delineation of obliterated bronchioles.


==Diffuse lung diseases==
==Diffuse lung diseases==
Line 207: Line 138:
|
|
|-
|-
|Follicular bronchiolitis/bronchitis
|[[Follicular bronchiolitis/bronchitis]]
|lymphoid cell around bronchioles / bronchus, normal parenchyma
|lymphoid cell around bronchioles / bronchus, normal parenchyma
|interstitial pattern
|interstitial pattern
Line 217: Line 148:
|stains to exclude lymphoma; germinal centres do not exclude [[lymphoma]]
|stains to exclude lymphoma; germinal centres do not exclude [[lymphoma]]
|-
|-
|Lymphoma (BALToma)
|Lymphoma ([[BALToma]])
|abundant lymphoid cells usu. in nodules
|abundant lymphoid cells usu. in nodules
|nodules / interstitial pattern
|nodules / interstitial pattern
Line 231: Line 162:


==Pulmonary nodular lymphoid hyperplasia==
==Pulmonary nodular lymphoid hyperplasia==
*[[AKA]] pseudolymphoma - a term some dislike.<ref name=afip_vol2_277>AFIP atlas of nontumour pathology. 2002. Vo. 2. P.277. ISBN 1-881041-79-4.</ref>
{{Main|Pulmonary nodular lymphoid hyperplasia}}
===General===
*Definition - reactive lymphoid cells.
 
===Gross/radiology===
*Has nodules radiographically.
 
===Microscopic===
Features:<ref name=afip_vol2_277>AFIP atlas of nontumour pathology. 2002. Vo. 2. P.277. ISBN 1-881041-79-4.</ref>
*Reactive lymphoid nodules.


Notes:<ref name=afip_vol2_281>AFIP atlas of nontumour pathology. 2002. Vo. 2. P.281. ISBN 1-881041-79-4.</ref>
==Lymphoma of the lung==
*Presence of germinal centres do '''not''' exclude lymphoma - may still be a [[BALToma]].
{{Main|Lymphoma of the lung}}
**BALT = bronchial/bronchus associated lymphoid tissue.
 
DDx:
*[[Lymphoma]], specifically [[MALToma|MALTomas/BALTomas]].
*[[Lymphocytic interstitial pneumonia]].
*Follicular bronchiolitis.


=[[Smoking]] associated disease=
=[[Smoking]] associated disease=
{{Main|Smoking}}
{{Main|Smoking}}
*RB = respiratory bronchiolitis.
*Respiratory bronchiolitis (RB).
*RBILD = respiratory bronchiolitis interstitial lung disease.
*[[Respiratory bronchiolitis interstitial lung disease]] (RBILD).
*DIP = desquamative interstitial pneumonia.
*[[Desquamative interstitial pneumonia]] (DIP).
*Eosinophilic granuloma (of lung) - [[AKA]] pulmonary langerhans cell histiocytosis.
*Eosinophilic granuloma (of lung) - [[AKA]] [[pulmonary langerhans cell histiocytosis]].
*[[Smoking-related interstitial fibrosis]] (SRIF).


All of the above are assoc. with smoking.  RBILD & DIP are considered by many to be on a continuum, i.e. RBILD is early DIP.
All of the above are associated with smoking.  RBILD & DIP are considered by many to be on a continuum, i.e. RBILD is early DIP.


==Respiratory bronchiolitis==
==Respiratory bronchiolitis==
Line 289: Line 206:
*Talc granulomatosis.
*Talc granulomatosis.
*Sarcoidosis.  
*Sarcoidosis.  
*Wegener granulomatosis.
*[[Granulomatosis with polyangiitis]] (Wegener granulomatosis).


==Sarcoidosis==
==Sarcoidosis==
Line 333: Line 250:
*[[AKA]] ''benign sclerosing pneumocytoma''.<ref name=pmid6291188>{{Cite journal  | last1 = Chan | first1 = KW. | last2 = Gibbs | first2 = AR. | last3 = Lo | first3 = WS. | last4 = Newman | first4 = GR. | title = Benign sclerosing pneumocytoma of lung (sclerosing haemangioma). | journal = Thorax | volume = 37 | issue = 6 | pages = 404-12 | month = Jun | year = 1982 | doi =  | PMID = 6291188 }}</ref>
*[[AKA]] ''benign sclerosing pneumocytoma''.<ref name=pmid6291188>{{Cite journal  | last1 = Chan | first1 = KW. | last2 = Gibbs | first2 = AR. | last3 = Lo | first3 = WS. | last4 = Newman | first4 = GR. | title = Benign sclerosing pneumocytoma of lung (sclerosing haemangioma). | journal = Thorax | volume = 37 | issue = 6 | pages = 404-12 | month = Jun | year = 1982 | doi =  | PMID = 6291188 }}</ref>
*Previously known as ''sclerosing hemangioma''.
*Previously known as ''sclerosing hemangioma''.
===General===
{{Main|Pneumocytoma}}
*Derived from type 2 pneumocyte.<ref name=pmid15138814>{{Cite journal  | last1 = Yamazaki | first1 = K. | title = Type-II pneumocyte differentiation in pulmonary sclerosing hemangioma: ultrastructural differentiation and immunohistochemical distribution of lineage-specific transcription factors (TTF-1, HNF-3 alpha, and HNF-3 beta) and surfactant proteins. | journal = Virchows Arch | volume = 445 | issue = 1 | pages = 45-53 | month = Jul | year = 2004 | doi = 10.1007/s00428-004-1023-3 | PMID = 15138814 }}</ref>
*Progesterone-receptor positive stromal cells.<ref name=pmid15731902>{{Cite journal  | last1 = Einsfelder | first1 = BM. | last2 = Müller | first2 = KM. | title = ["Pneumocytoma" or "sclerosing hemangioma": histogenetic aspects of a rare tumor of the lung] | journal = Pathologe | volume = 26 | issue = 5 | pages = 367-77 | month = Sep | year = 2005 | doi = 10.1007/s00292-005-0751-8 | PMID = 15731902 }}</ref>
 
====Epidemiology====
*Female in 40s.<ref name=pmid19415961>{{Cite journal  | last1 = Keylock | first1 = JB. | last2 = Galvin | first2 = JR. | last3 = Franks | first3 = TJ. | title = Sclerosing hemangioma of the lung. | journal = Arch Pathol Lab Med | volume = 133 | issue = 5 | pages = 820-5 | month = May | year = 2009 | doi =  | PMID = 19415961 }}</ref>
*Considered benign; excision is curative.
**Rare case reports of [[metastases]].
 
===Gross===
*Peripheral, solitary.
*Well-circumscribed.
 
===Microscopic===
Features:<ref name=pmid19415961>{{Cite journal  | last1 = Keylock | first1 = JB. | last2 = Galvin | first2 = JR. | last3 = Franks | first3 = TJ. | title = Sclerosing hemangioma of the lung. | journal = Arch Pathol Lab Med | volume = 133 | issue = 5 | pages = 820-5 | month = May | year = 2009 | doi =  | PMID = 19415961 }}</ref>
*Mixed cell population.
*Variable architecture:
**Papillary.
**Sclerotic.
**Solid.
**Hemorrhagic.
* +/-Granulomas.
 
DDx:<ref>URL: [http://www.med.muni.cz/biomedjournal/pdf/2004/01/37_42.pdf http://www.med.muni.cz/biomedjournal/pdf/2004/01/37_42.pdf]. Accessed on: 17 June 2010.</ref>
*Papillary adenoma.
*[[Neuroendocrine tumour]] (carcinoid).
 
Image:
*[http://moon.ouhsc.edu/kfung/jty1/Com/ComImage/Com309-1-SM2.gif Pneumocytoma (ouhsc.edu)].<ref>URL: [http://moon.ouhsc.edu/kfung/jty1/Com/Com309-1-Diss.htm http://moon.ouhsc.edu/kfung/jty1/Com/Com309-1-Diss.htm]. Accessed on: 14 April 2012.</ref>
 
===IHC===
Features:<ref name=pmid10716159>{{Cite journal  | last1 = Rodriguez-Soto | first1 = J. | last2 = Colby | first2 = TV. | last3 = Rouse | first3 = RV. | title = A critical examination of the immunophenotype of pulmonary sclerosing hemangioma. | journal = Am J Surg Pathol | volume = 24 | issue = 3 | pages = 442-50 | month = Mar | year = 2000 | doi =  | PMID = 10716159 }}</ref>
*EMA +ve.
*PR +ve.<ref name=pmid15731902>{{Cite journal  | last1 = Einsfelder | first1 = BM. | last2 = Müller | first2 = KM. | title = [Pneumocytoma or sclerosing hemangioma: histogenetic aspects of a rare tumor of the lung]. | journal = Pathologe | volume = 26 | issue = 5 | pages = 367-77 | month = Sep | year = 2005 | doi = 10.1007/s00292-005-0751-8 | PMID = 15731902 }}</ref>
 
Negative stains:<ref name=pmid10716159/>
*SMA -ve.
*[[CEA]] -ve.
*CD34 -ve.
*S100 -ve.
*Chromogranin A -ve.
 
Others:<ref name=pmid15138814/>
*[[TTF-1]] +ve.
*HNF-3 alpha +ve.
*HNF-3 beta +ve.


==Lymphangioleiomyomatosis==
==Lymphangioleiomyomatosis==
Line 391: Line 263:
==Diffuse panbronchiolitis==
==Diffuse panbronchiolitis==
*Abbreviated ''DPB''.
*Abbreviated ''DPB''.
===General===
{{Main|Diffuse panbronchiolitis}}
*Rare lung disease predominantly found among asians.<ref name=pmid17012632 >{{Cite journal  | last1 = Poletti | first1 = V. | last2 = Casoni | first2 = G. | last3 = Chilosi | first3 = M. | last4 = Zompatori | first4 = M. | title = Diffuse panbronchiolitis. | journal = Eur Respir J | volume = 28 | issue = 4 | pages = 862-71 | month = Oct | year = 2006 | doi = 10.1183/09031936.06.00131805 | PMID = 17012632 | http://erj.ersjournals.com/content/28/4/862.long }}</ref>
*Has been likened to [[cystic fibrosis]] - but doesn't really share any features with it.
===Gross===
Features:<ref name=pmid17012632/>
*[[Bronchiectasis]].
*Hyperinflation.
*Small nodules (~2-3 mm) around the small airways.
*Diffuse involvement of both lungs.
 
===Microscopic===
Features:<ref name=pmid17012632/>
*Transmural inflammation of bronchioles - esp. respiratory bronchioles.
**Lymphocytes, plasma cells, histiocytes.
*Neutrophils within the airway.
 
Images:
*[http://erj.ersjournals.com/content/28/4/862/F1.expansion.html DPB (ersjournals.com)].


==Pulmonary amyloidosis==
==Pulmonary amyloidosis==
Line 452: Line 307:
=Eosinophilic pneumonia=
=Eosinophilic pneumonia=
Specific entities:<ref name=emedicine301070>[http://emedicine.medscape.com/article/301070-overview http://emedicine.medscape.com/article/301070-overview]</ref>
Specific entities:<ref name=emedicine301070>[http://emedicine.medscape.com/article/301070-overview http://emedicine.medscape.com/article/301070-overview]</ref>
*[[Churg-Strauss syndrome]].
*[[Eosinophilic granulomatosis with polyangiitis]] (Churg-Strauss syndrome).
*Acute eosinophilic pneumonia.
*Acute eosinophilic pneumonia.
*Chronic eosinophilic pneumonia.
*Chronic eosinophilic pneumonia.
Michael
49,006

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/43602...47176"

Navigation menu