w-orksh** 18

Respiraia;y pa f*oiog3. lI
Topie

}-{ICR*SC*PY
. Interstitialpneumonia
. Interstitial pneumaaia with Pnerrr**eystis carinii
ider::castrativ= e)
. Fulmonarytubercul+sis
- Hyaiiae mer';braae disease
" Silic*sis

EfACRGSCiiFY
. Fuim*narytubercuicsis
. Bronc.ho-pulmonary carcinoma

F-{FCR*SC*PV

Inf srstif ial p*ex rmex i*

' Atyp'i*el pnel.:n:*ais $!+*ns ghe absen+* +f tire rntra*alEe*lar cx,Jdet+
" Interstitial rneans the inflammatcry exude.te is located in the alvealar I'ralls
. Eticlcgy:
Mirc*pias;*a p;:eumonia*
Viruses - infrtrenze, respiratcr_v sinciiiai. measies
.4,.{ier*se<rpy
' aeuteneerCItisingbrr:nchioiitis
. alveolar wails,
m+a*nuclear in{larnmat*ry infiitrate {lyrnphccytesi and edeara
parieto-alveoiar capillary congestion
--* thickeiiiag ofthe alveolat -*-ail with sreatioa of an alveola-capillarv'
L]ILTL-K

Aiveolar lume* is free

Esterstiti*l p*eiime*ia wi€h P*exmcrcysiis tsrEttii

. It ceeiirs in c*llectiviti*s af dystr*phie infarits and childr** rvirh repeated
hospitali zatic* s {AIDS}
* Etial*gy: Pnzum*eystis sarisii
t Aiveoiar walls:
i:lflammati*a wit?: lymphcei'tes and plasma cells:*ith thicke*ing *f tl':e
1?

Aive,tlar iumea: foamy exudaie looking as "scap bub,bles"

P*kncnary ir:bereulssis
" Fr:kncnary inftctious diseaee wiih aercgerue traiismittion caused by M
tuberculosis determiniag graaulcnlatous infl ammation
 - 'r-.,*^-
r yuss
Primary {prirnai nfec.ti on}
. shildhoad
Secandary {reir:fe-etian or reactivaiiaa}

P! i*oscopy - tu n*.,,i;XllHX.',.,,,-
e 't fw.ec ni celic
-
- muitinucieated Langhans giant ceils
epitheJic':d ceJl-t
sp+cifi e serrsiii'ing T i=;mph+eites
. Feafures,
D,.-:^^
t I-lSltJlt

F* ecrasis cf cazei frcat ian

Hyaline rnembr*ne dise*se

. lt oecurs in premature newbcrns
" Cause. instrilicienc'; in aiveciar surfac€ant f*mati*n
Microscopy
. eolapsed. un-expanded alvenli
" Alve.alar chaneifs and alveoii are iined by eosinophilie homagene*us mernbranes
{ h,1,al in * mem hra* e*s}
+:1**:* *..,^^*.-t: .^t -*:,{^.,
I lt.,r rlir trruL.Jpurtagtrfl trJtlr
alveclar cel I neci-osis
. It resr:lts sn slr,'ss*{*-eapillary bl*ek, eausing *eute respira-tor''; distr*ss
c:l: -- -:-
. It is a pneumocani<lsis caused by inhaling silica dust
. -: - the cirarac.teristic iesion: siiic.otic riuduie
iv{ie.roscspy
rrcduiar iesrcn
concentrie collagen fibers {blue colored}
beiiveea theiii cait be highli-ehted to the ligirt polarized micrcscope
birefiinsente silica crvstats

ryIACEIOSCSFY

PULMONARY TUBERCUTOSIS
" Pulmcind{v iubercui*sis iTB} is an infectiaus lung disease w:iih air transmittiog
determined b-y M. tuberculoiis" which causes a tiisuiar granulomatous
iaflammati*n.
. Tuberculous granulom* is the morphaiogical substrate clTB:
o'-:"':H,'J*l,Tj:?T".,|;:jr,ix;["{;.ffff
L?i
' mcn*rtlieiear +eils - mai:riy iyrxphacat+s {L3ri
Cider granulomas: it present to the periphery rim of fibroblasts and
fi brous ronnective tissue
Types sf Fi:im**ary Tubmillssis-TB
A. Primary
E. Secondan
 Primary pi:irno**ry TB
a chi I ihc*d tuberculcsi s ipri rrrary infecti on).
' l*fecticsl rlcfurs thr*ugfr iahalarioa *fM. tubereelasis. wirich ca*ses fire
fc*q-rrrxi*it +f t** characteristis. lesi<.*s
. The characteristic lesions af primary infectioir:
a. Ghan scmcler
Ghcn f*cus
Tbc limphade*itis
#. pregrsssio.'e pdmar-r.' pulmanarl' fu$ercui*sis
E',,olutiorr af Gh+n ccmr-rlex
. Favcrable.
Healir:g'+iith ijbraus sear t?--rrnati+a- ctr en,i:a suiatian and caicificatian
i,:ure'j pni:]arir +t--rn:pi exi
M. tuberculosis can persist in a latent furni {latent tubercglosisi
' Uniar.*rable
prcgres sir: e pri mar'; puim+nary.. tubcreulcsi s
b. Fregressive primary p*lmonary tuberculssis
. Cazesus pneumonia
. Tubersuicus caverna
. Ple*raj effusirrs
' il.€iitiarl t'-:bercul*sis
Seroudary Tub*er:I*sis
ii is $r*:iiiested as.
a. Apical ***ular iesions {"Assmaaa focus'}
b. Frogre ssi r,-e secorrrjary pu I *:*nar,v t u i: ertu ir: sj s

Evolutian ef Apieat aadular lesians {..Assmann feeus"}

. Fav*rab!*:
Heali ng b.v-.- iibrosi s aad cai cii-i caticn
. Lrnfhvorabie iwitirout treatme*ti
Pr*gr*ssive sec*ndary prilmr-r::a,iy tub*reu1,:sis
b. Progressive sef, sndary pul*ronary t*berculosis
1. Apicai tubercuio*s infiltrate
- Apieai rel;ercr:iaus iniliirate resuiis b'y exjensicn aicazecus aecr+sis t+ ?he
entire iung apex (fr*m Assrsann focus)
r Masroscopicaiiy, iirere is an extensive apical area of cazcous ilsrrosis witi:
,iestructicrr *f rr,:rrin=l iurrg siructr:re ilac*: cf ai-rtirrac',.-tic pigmerrt)
r In ev,:lution, prcgressing io apicai *ribrc-cazecus cavitary iuberculosis
2. api*ai irbra-cazecus ea\..itary tubercui{-;si s
e Apical i ecent 'Javernae
* Different fcrms *f tuberculaus disseminati*n
i. ?ubeiculous bronci:*pneumcnia
z. Miiliarv ii.r-berculcsis
3. Sero-flbrinous pieuresia
 3. Adva;iced fr-bro-caeeous caviiary' tiii:erculcsis
. Invoivement ol i, niore than one, or ail puimonary lebes
. Cha::acteristic lesir:rs
cl d *ia verna-e'i..r,.'iih r.'ari** s ii gi;'ib cli ic:;
o'
":* 1i;[:-J:?i:;:*:"*s em i a at i o n

. &.tiilia,,i. _.ubersuicsis
. Ser+-frbrin*uspieuresy
Dge t+ exte*-*ian althe inJla:r:::':e:ia* l+ ii:e r,.isc*;al pler::e
ii*a,iin g i; rv fi brr: si s r'": itir intr-apienrai a,j irei enr-. e fo iila r i err
4!. qvrnr-L' ^ j^
rPierrrrI
rLur ar s-1 rrrpii_! 5I5

It results b-y' conneciive ai-aaii'izaiicn i;f pieuial ser*-fibriiicus exudate witir iorniation
af acinei-enccs bctw'een the tw'o plci;i-ai ia'uei-s and fibi-cits liiickening oi'thcm

BR+NCH *FLTLSf *NA RY TLI MGPTS

. There are 3 major categcries oiiung tumors.
secondan' lung tumnrs
br*nehcpiii r,r*;:ar ca:gitr* *:a
bronchopulmonar hrenign furnors
. Mei-st tiimcrs are r*aliq$aslt*:-a*t*-ste*ses

t, Er.:rrchap*lmenar earcincm* {CBP}

It ir +h+ mnr* c,rmmnn lrrnc tiisnr
'.",.'"''-
The n:ajai risi,: i'a,rors are represented'uri'srnoi:ing, an,i in,iustr-iai air paiiuianrs
(asbestosi, radiatioa, genetic factcrs

Drigin
. r;sus!!r,:, the tum+r has origin in the main irronchial epitheiium (orrler i, ii, iII; and
mucous glandular epithelium.
Lccaticn
. After lscatisn, there are 2 ruacr*seopical types:
iai tire ser:trsJ I i:ilar turncr {irfiJrraiirie tun:*ri
r !'4iar*.n=e**ir.+!!r. l"rr.^,n'-hi*i ;':rc::r<^.ln+ !ht!=r f r rmrlr! ic q f r rmr:r rr,hirh r*,hltn r,-i r
brcncliial lurr,en and inliltrates bron*hiai -rvell with extending into iung
^o.o--hr,^rq ln nrrlr*nrrqr'r, *lo,rt,-
iiri tir+ nprin i:prq i ir i *1,1r* ir'.r.i iiiq r ir r rrir^rr-\r
. Macroscopieally, is a buiky. ncdular tumor. single or multiple, white-gray in
solor. soiiri. vritir iiresuiar mar*qins. because oilocai infiitrative ieature. The
tumor coniains areas of-necrosis and hemorrhaqe.

lI. Secandarv luftg tuniors or- lui-rg rieiasias€S

. Mscroscopically" the tumcrs appeer as *rultiple nodules, clearly defined, various
sizes, with random distribution w-ithin bilateral lung lobes.