Respiratory system pathology lab

1. ١

2. the dilated airspaces (distal).
the emphysematous process is one of loss of lung parenchyma, not fibrosis.
There are two major types of emphysema: centrilobular (centriacinar) and
panlobular (panacinar). The former involves primarily the upper lobes while the
latter involves all lung fields, particularly the bases. Centrilobular emphysema
occurs with loss of the respiratory bronchioles in the proximal portion of the
acinus, with sparing of distal alveoli. This pattern is most typical for smokers.
Panacinar emphysema occurs with loss of all portions of the acinus from the
respiratory bronchiole to the alveoli. This pattern is typical for alpha-1-antitrypsin
deficiency.
the dilated airspaces (distal).
the emphysematous process is one of loss of lung parenchyma, not fibrosis.
There are two major types of emphysema: centrilobular (centriacinar) and
panlobular (panacinar). The former involves primarily the upper lobes while the
latter involves all lung fields, particularly the bases. Centrilobular emphysema
occurs with loss of the respiratory bronchioles in the proximal portion of the
acinus, with sparing of distal alveoli. This pattern is most typical for smokers.
Panacinar emphysema occurs with loss of all portions of the acinus from the
respiratory bronchiole to the alveoli. This pattern is typical for alpha-1-antitrypsin
deficiency.
٢

3. Microscopically at high magnification, the loss of alveolar walls with
emphysema is demonstrated. Remaining airspaces are dilated.
Microscopically at high magnification, the loss of alveolar walls with
emphysema is demonstrated. Remaining airspaces are dilated.
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4. - The diagnostic feature of chronic bronchitis in the trachea and larger bronchi is
secreting glands-enlargement of the mucus
- The magnitude of the increase in size is assessed by the ratio of- the thickness of the
submucosal gland layer to that of the bronchial wall (the Reid index-normally 0.4).
- The diagnostic feature of chronic bronchitis in the trachea and larger bronchi is
secreting glands-enlargement of the mucus
- The magnitude of the increase in size is assessed by the ratio of- the thickness of the
submucosal gland layer to that of the bronchial wall (the Reid index-normally 0.4).
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5. Spirals).Curschmann(The mucous contain whorls of shed epithelium
(collections of crystalloids made up ofLeyden crystals-CharcotwitheosinophilsNumerous
eosinophil proteins)
Spirals).Curschmann(The mucous contain whorls of shed epithelium
(collections of crystalloids made up ofLeyden crystals-CharcotwitheosinophilsNumerous
eosinophil proteins)
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6. ٦

7. -Is the permanent dilation of bronchi and bronchioles (proximal)
-destruction of the muscle and the supporting elastic tissue, resulting from or associated
with chronic necrotizing infections
-Is the permanent dilation of bronchi and bronchioles (proximal)
-destruction of the muscle and the supporting elastic tissue, resulting from or associated
with chronic necrotizing infections
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8. ٨

9. Well-defined granulomas are seen here. They have rounded outlines. The one
toward the center of the photograph contains several Langhans giant cells.
Granulomas are composed of transformed macrophages called epithelioid cells
along with lymphocytes, occasional PMN's, plasma cells, and fibroblasts. The
localized, small appearance of these granulomas suggests that the immune
response is fairly good.
Without caseation
e.g.sarcoidosis
Well-defined granulomas are seen here. They have rounded outlines. The one
toward the center of the photograph contains several Langhans giant cells.
Granulomas are composed of transformed macrophages called epithelioid cells
along with lymphocytes, occasional PMN's, plasma cells, and fibroblasts. The
localized, small appearance of these granulomas suggests that the immune
response is fairly good.
Without caseation
e.g.sarcoidosis
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10. The edge of a granuloma is shown here at high magnification. At the upper right
is amorphous pink caseous material composed of the necrotic elements of the
granuloma as well as the infectious organisms. This area is ringed by the
inflammatory component with epithelioid cells, lymphocytes, and fibroblasts.
The edge of a granuloma is shown here at high magnification. At the upper right
is amorphous pink caseous material composed of the necrotic elements of the
granuloma as well as the infectious organisms. This area is ringed by the
inflammatory component with epithelioid cells, lymphocytes, and fibroblasts.
١٠

11. noncaseating epithelioid granuloma‫ﺳﺎرﻛوﯾد‬
compact collection of epithelioid cells rimmed by an outer zone of CD4+ T cells and the
epithelioid cells are derived from macrophages
multinucleated giant cells in the centre
noncaseating epithelioid granuloma‫ﺳﺎرﻛوﯾد‬
compact collection of epithelioid cells rimmed by an outer zone of CD4+ T cells and the
epithelioid cells are derived from macrophages
multinucleated giant cells in the centre
١١

12. In order to find the mycobacteria in a tissue section, a stain for acid fast bacilli
is done (AFB stain). The mycobacteria stain as red rods, as seen here at high
magnification.
In order to find the mycobacteria in a tissue section, a stain for acid fast bacilli
is done (AFB stain). The mycobacteria stain as red rods, as seen here at high
magnification.
١٢

13. -Lymphocytes predominate
indicating type III hypersensitivity
-- Interstitial noncaseating granulomas are present in more than two thirds of cases,
usually in a peribronchiolar location
-
suggests a role for type IV hypersensitivity as well
-Lymphocytes predominate
indicating type III hypersensitivity
-- Interstitial noncaseating granulomas are present in more than two thirds of cases,
usually in a peribronchiolar location
-
suggests a role for type IV hypersensitivity as well
١٣

14. Regardless of the etiology for restrictive lung diseases, many eventually lead to
extensive fibrosis. The gross appearance, as seen here in a patient with
organizing diffuse alveolar damage, is known as "honeycomb" lung because of
the appearance of the irregular air spaces between bands of dense fibrous
connective tissue.
Regardless of the etiology for restrictive lung diseases, many eventually lead to
extensive fibrosis. The gross appearance, as seen here in a patient with
organizing diffuse alveolar damage, is known as "honeycomb" lung because of
the appearance of the irregular air spaces between bands of dense fibrous
connective tissue.
١٤

15. idiopathic pulmonary fibrosis… The alveolitis that produces fibroblast
proliferation and collagen deposition is progressive over time.
Patchy
The typical finding is the existence of both early and late lesions called (temporal
heterogeneity)
The earliest lesions demonstrate exuberant fibroblastic proliferation and appear as
fibroblastic foci
The cut surface shows fibrosis (firm, rubbery white areas), with lower lobe predominance
and a distribution in the subpleural regions and along the interlobular septa
The pleural surfaces of the lung have the appearance of cobblestones
idiopathic pulmonary fibrosis… The alveolitis that produces fibroblast
proliferation and collagen deposition is progressive over time.
Patchy
The typical finding is the existence of both early and late lesions called (temporal
heterogeneity)
The earliest lesions demonstrate exuberant fibroblastic proliferation and appear as
fibroblastic foci
The cut surface shows fibrosis (firm, rubbery white areas), with lower lobe predominance
and a distribution in the subpleural regions and along the interlobular septa
The pleural surfaces of the lung have the appearance of cobblestones
١٥

16. ١٦

17. On histologic examination, cryptogenic organizing pneumonia is characterized by the
presence of polypoid plugs of loose organizing connective tissue within alveolar ducts,
alveoli, and often bronchioles
The connective tissue is all of the same age, and the underlying lung architecture is normal
On histologic examination, cryptogenic organizing pneumonia is characterized by the
presence of polypoid plugs of loose organizing connective tissue within alveolar ducts,
alveoli, and often bronchioles
The connective tissue is all of the same age, and the underlying lung architecture is normal
١٧

18. Hyaline membrane
١٨

19. in which endothelial proliferation,lesionsplexiform
forms multiple lumina within small arteries where they branch from a medium-sized
artery.
in which endothelial proliferation,lesionsplexiform
forms multiple lumina within small arteries where they branch from a medium-sized
artery.
١٩

20. ٢٠

21. ٢١

22. This is the microscopic appearance of squamous cell carcinoma…..nests
keratin pearls and intercellular bridges
This is the microscopic appearance of squamous cell carcinoma…..nests
keratin pearls and intercellular bridges
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23. Gross apperance of primary rather than metastatic.
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24. Microscopically, the bronchioloalveolar carcinoma is composed of columnar
cells that proliferate along the framework of alveolar septae. The cells are well-
differentiated. These neoplasms in general have a better prognosis than most
other primary lung cancers.
Microscopically, the bronchioloalveolar carcinoma is composed of columnar
cells that proliferate along the framework of alveolar septae. The cells are well-
differentiated. These neoplasms in general have a better prognosis than most
other primary lung cancers.
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