Respi Lab Session (Sem 3)

  • By: Terri
  • Date: October 1, 2009
  • Time to read: 3 min.

Lung: Bronchiectasis

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  • Show a resected upper lobe with with widely dilated bronchi.
  • Thickening of the bronchial walls
  • Collapse & fibrosis of the pulmonary parenchyma

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Lung: Acute Pneumonia

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  • Microscopic photograph

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Lung: Pulmonary Embolism

Pulmonary embolism (2)

  • Seen in the pulmonary artery to the left lung on cut section is a large pulmonary thromboembolus
  • Such thromboemboli typically originate in the leg veins/pelvic veins of persons who are immobilized

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Squamous Cell Carcinoma of Lung

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  • Microscopic appearance of squamous cell carcinoma with nests of polygonal cells with pink cytoplasm and distinct cell borders.
  • The nuclei are hyperchromatic.
  • The center shows attempted keratin pearl formation, sign of differentiation.

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Mycobacterium tuberculosis of lung – AFB stain

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  • This is an acid fast stain of Mycobacterium tuberculosis (MTB).
  • Note the red rods – hence the terminology for MTB in histologic sections/smears: acid fast bacilli

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Lung: Emphysema

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  • Alveolar walls are thin, atrophic & have broken down to form large spaces
  • Thick arrow: Collection of pigment laden macrophages seen.

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Bronchogenic carcinoma (Lung cancer)

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  • There is a large, gray white to dull yellow neoplastic growth arising from the bronchus
  • Solid in nature
  • with ill defined margins
  • There is also deposition of anthracotic pigment in the lung parenchyma elsewhere.

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Lung: Carcinoma

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  • Specimen of lung shows large, irregular, firm, gray white mass extending from the hilum to pleura
  • The black areas are the anthracotic pigments trapped in the tumor.
  • Tumors arising in the hilum are commonly squamous cell carcinomas as in this case.

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Ghon focus

 DSC07575

  • Initial infection with Mycobacterium Tuberculosis in an incompetent individual
  • Usually occurs in an upper region of the lung producing a sub-pleural lesion called a Ghon focus (RED ARROW)
  • YELLOW ARROW: Focal areas of emphysematous change is also seen.

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Miliary Tuberculosis

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  • Miliary tuberculosis can occur when tuberculous lung lesions erode pulmonary veins/systemic veins.
  • This results in dissemination of tubercle bacilli producing myriads of 1-2 mm lesions in susceptible hosts.’
  • Miliary spread limited to the lungs can occur following erosion of pulmonary arteries by tuberculous lung lesions.

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Mesothelioma of the pleura

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  • This is pleural mesothelioma encasing the right lung completely along with the mediastinum.
  • There is marked thickening of the pleura due to the tumour.
  • And the mediastinum structures are compressed.

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Lung: Metastatic deposits

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  • Shows extensive, metastatic deposits distributed in a random fashion in the lung parenchyma.
  • The site of the deposits vary, and appear grayish white in colour.

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Mesothelioma of pleura

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  • Mesothelioma is a rare cancer arising from the mesothelial cells.
  • These tumors usually arise in the visceral/parietal pleura, peritoneum and pericardium.
  • The dense white encircling tumor mass is arising from the visceral pleura.
  • These are big bulky tumors that fill the chest cavity.
  • The risk factor for mesothelioma is asbestos exposure.

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Lung: Chronic pneumonia

  • Inflammatory cells
  • Macrophages
  • Inflamed alveolar spaces

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Lobar pneumonia

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FIGURE 1

  • This is a lobar pneumonia in which consolidation of the entire left upper lobe has occured.

FIGURE 2

  • A clearer view of the lobar pneumonia demonstrates the distinct difference between the upper lobe and the consolidated lower lobe (ARROW)

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Bronchopneumonia

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  • ARROWS: The lighter areas that appear to be raised on cut surface from the surrounding lung are the areas of consolidation of the lung.
  • The patchy consolidated areas here very closely match the pattern of lung lobules.
  • Typical bacterial organisms include:- Staphylococcus aureus, Klebsiella, E.Coli, Pseudomonas.

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Lung: Fibrosing alveolitis

  • Dense interstitial sacs
  • Scant inflammatory cells
  • Dense fibrosis

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Emphysema

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Bronchiectasis

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