Difference between revisions of "Diffuse lung diseases"

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Diffuse lung diseases (view source)

Revision as of 12:50, 18 April 2014

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→‎Diffuse alveolar damage: split out
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==Diffuse alveolar damage==
==Diffuse alveolar damage==
*Abbreviated ''DAD''.
*Abbreviated ''DAD''.
===General===
{{Main|Diffuse alveolar damage}}
Etiology:
*Abrupt hypoxemia with pulmonary infiltrates leading to epithelial cell and endothelial cell death not accompanied by cardiac failure.<ref name=Ref_PCPBoD8_364>{{Ref PCPBoD8|364}}</ref>
 
DAD is the histologic correlate of:
*Acute respiratory distress syndrome (ARDS).
**[[AKA]] adult respiratory distress syndrome (ARDS) to differentiate it from ''[[respiratory distress syndrome]]'' in infants.
*Acute interstitial pneumonia (AIP).
*Transfusion related acute lung injury (TRALI).
 
The DDx is broad:<ref>{{Ref WMSP|91}}</ref>
*Infection/sepsis.
*Toxic (smoke, oxygen).
*Drug (amiodarone, chemotherapy).
*Trauma/shock.
*Inflammatory.
*Idiopathic.
 
===Microscopic===
Features:<ref name=Ref_Klatt103>{{Ref Klatt|103}}</ref><ref name=pmid16766248>{{Cite journal  | last1 = Castro | first1 = CY. | title = ARDS and diffuse alveolar damage: a pathologist's perspective. | journal = Semin Thorac Cardiovasc Surg | volume = 18 | issue = 1 | pages = 13-9 | month =  | year = 2006 | doi = 10.1053/j.semtcvs.2006.02.001 | PMID = 16766248 }}</ref>
#Exudative:
#*Hyaline membranes - '''key feature'''.
#**Debris (pink crap) lines the alveolar spaces.
#Proliferative:
#*Interstitial thickening.
#*Inflammation (lymphocytes).
#*Hobnailing of alveolar lining cells (type 2 pneumocyte hyperplasia<ref>URL: [http://d3jonline.tripod.com/20-Pulmonary_II/Pathology_of_Interstitial_Lung_Diseases.htm http://d3jonline.tripod.com/20-Pulmonary_II/Pathology_of_Interstitial_Lung_Diseases.htm]. Accessed on: 22 February 2012.</ref>).
#*Edema (link pink crap in the alveoli).
#*[[Masson bodies]] in the airway.
#*Hyaline material (usu. focal) - '''key feature'''.
#Fibrotic:
#*Interstitial inflammation.
#*Fibrosis.
 
DDx:<ref name=pmid16766248>{{Cite journal  | last1 = Castro | first1 = CY. | title = ARDS and diffuse alveolar damage: a pathologist's perspective. | journal = Semin Thorac Cardiovasc Surg | volume = 18 | issue = 1 | pages = 13-9 | month =  | year = 2006 | doi = 10.1053/j.semtcvs.2006.02.001 | PMID = 16766248 }}</ref>
*[[Cryptogenic organizing pneumonia]] - especially for ''proliferative phase DAD''.
*[[Bronchiolitis obliterans]].
 
====Images====
<gallery>
Image:Hyaline membranes - low mag.jpg | Exudative phase DAD - low mag. (WC/Nephron)
Image:Hyaline membranes - intermed mag.jpg | Exudative phase DAD - intermed. mag. (WC/Nephron)
Image:Hyaline membranes - high mag.jpg | Exudative phase DAD - high mag. (WC/Nephron)
Image:Hyaline membranes - very high mag.jpg | Exudative phase DAD - very high mag. (WC/Nephron)
Image:ARDS.jpg | Exudative DAD (WC)
</gallery>
www:
*[http://www.flickr.com/photos/pulmonary_pathology/4710141110/in/photostream/ Proliferative phase DAD - intermed. mag. (flickr.com/Yale Rosen)].
*[http://www.flickr.com/photos/pulmonary_pathology/4709499629/in/photostream/ Proliferative phase DAD - high mag. (flickr.com/Yale Rosen)].


==Usual interstitial pneumonia==
==Usual interstitial pneumonia==
Michael
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