Transcript Pulmonary Pathology I Lab November 25, 2013

Pulmonary Pathology I Lab
November 25, 2013
Pulmonary Pathology I
Case 1
Q1 Describe the gross findings
Normal
Fresh, unfixed
specimen
Q2 Describe the gross findings
Normal, Cut surface,
Formalin Fixed Specimen
Q3 Name the structure. Name A-C.
A
B
C
Q4 Describe the histologic findings.
Name A-D.
Q5. Describe the histologic findings
Pulmonary Pathology 1
Case 2
Case History
A 67-year-old man presents with dyspnea. He
also complains of cough, which is worse in the
mornings, off and on for several years. There
is no history of fever or purulent sputum or
cyanosis. He smokes two packs of
cigarettes/day for the last 50 years.
On exam there is hyper-resonance of the
chest by percussion and prolonged expiratory
phase on auscultation.
Q1 Describe the gross findings. Comment
on “A”.
A
Q2 Describe the primary abnormality.
Q3 Describe the histologic findings.
Q4 Describe the histologic findings.
Correlate with the gross specimen.
Q5 What is your diagnosis?
Q6 What is the most common etiology of this
disease process? Summarize the pathogenesis.
Q7 What underlying genetic disorder(s) can
contribute to the development of this disease
process?
Q8 Correlate the morphologic findings
with the classic radiographic findings.
Pulmonary Pathology I
Case 3
Case History
A newborn develops respiratory insufficiency.
He was born at 25 weeks gestation and weighed
500 gm at birth. The mother had fever for 3
days before delivery and the amniotic fluid was
purulent. Surfactant and antibiotics were
administered. The baby’s condition deteriorated
rapidly and he died 8 hours later.
Q1 Describe the gross findings. Compare to
the normal lung from case 1
Low power
High power
Q2 Describe the histologic findings. What is the
structure highlighted by the arrows composed of?
Q3 Diagnosis?
Q4 Describe the pathogenesis of this disease
process.
Q5 Newborns who ultimately survive this
disease process will have received high
concentrations of ventilator-administered
oxygen for prolonged periods: Name the two
most common associated complications
Pulmonary Pathology 1
Case 4
Case History
A 44-year-old woman undergoing
chemotherapy for metastatic ovarian cancer is
admitted to the hospital with a severe
infection and sepsis. Over the next 2 days she
develops progressive dyspnea. She becomes
hypoxic and cyanotic and requires increasing
oxygen concentration.
Chest X-ray shows diffuse bilateral infiltrates.
Q1 Describe the gross findings. Compare to
the normal lung from case 1.
Low power
Q2 Describe the histologic findings
High Power
Q3 Diagnosis?
Q4 List the most common etiologies of this
condition.
Q5 Summarize the pathogenesis.
Pulmonary Pathology 1
Case 5
Case History
A 56 year-old man develops progressive dyspnea
over 6-8 months. He denies fever, chest pain or
hemoptysis. He has never smoked cigarettes.
On physical exam he is hypoxemic. On chest
auscultation there are fine bibasilar inspiratory
crackles (sound like Velcro)
Chest X-ray shows bilateral interstitial infiltrates
with a peripheral distribution.
Q1 Describe the gross findings.
Compare to normal lung.
Q2 Describe the key finding depicted
in the images.
Q3 Describe the histologic findings. Correlate
the gross/radiographic images with the
histology.
Q4 Diagnosis?
Q5 List diseases that may result in this process.
Pulmonary Pathology 1
Case 6
Case History
A 33-year old African American woman is involved
in a motor vehicle accident. She sustained minor
chest and head trauma. The patient is healthy,
works as a school-teacher, and has never smoked.
She takes no prescription or over the counter
medications. Physical exam is notable for a frontal
head hematoma and is otherwise unremarkable.
In the ED a head CT and chest-ray were performed.
Q1 What is the primary abnormality on
this radiograph?
A biopsy is performed.
Q3 Describe the histologic findings.
Q4 Are there any special stains that should be
performed on the biopsied tissue before
rendering a diagnosis?
Q5 The stains ordered are negative. What is the
most likely diagnosis?
Q6 Summarize the known or hypothesized
elements of the pathophysiology of this disease
process.
Q7 Are there extrapulmonary/extrathoracic
lesions in this disease process? If so, what
organs are most commonly involved and what
are the associated clinical manifestations?
End of Pulmonary Pathology I