Pulmonary pathology - Revision history

Michael at 18:31, 24 November 2022

2022-11-24T18:31:52Z

← Older revision		Revision as of 18:31, 24 November 2022
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	Metaplastic changes:		Metaplastic changes:
	*Goblet cells.<ref>{{cite journal \|authors=Rogers DF \|title=The airway goblet cell \|journal=Int J Biochem Cell Biol \|volume=35 \|issue=1 \|pages=1–6 \|date=January 2003 \|pmid=12467641 \|doi=10.1016/s1357-2725(02)00083-3 \|url=}}</ref>		*Goblet cells - described in association [[asthma]] and [[COPD]].<ref>{{cite journal \|authors=Rogers DF \|title=The airway goblet cell \|journal=Int J Biochem Cell Biol \|volume=35 \|issue=1 \|pages=1–6 \|date=January 2003 \|pmid=12467641 \|doi=10.1016/s1357-2725(02)00083-3 \|url=}}</ref>
	*Squamous - may precede dysplasia and malignancy.		*Squamous - may precede dysplasia and malignancy.

Michael at 18:30, 24 November 2022

2022-11-24T18:30:28Z

← Older revision		Revision as of 18:30, 24 November 2022
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	===Lung histology===		===Lung histology===
	====Bronchial ~~cells~~====		====Bronchial mucosa====
	*Ciliated pseudostratified epithelium.		*Ciliated pseudostratified epithelium.
			*Minimal/mild inflammation.
			*Small amount of smooth muscle.

	Metaplastic changes:		Metaplastic changes:
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	*Squamous - may precede dysplasia and malignancy.		*Squamous - may precede dysplasia and malignancy.

	====Lung ~~cells~~====		====Lung parenchyma====
	Common:		Common:
	*Type I pneumocyte - cover most of the alveolar surface.		*Type I pneumocyte - cover most of the alveolar surface.

Michael at 18:26, 24 November 2022

2022-11-24T18:26:42Z

← Older revision		Revision as of 18:26, 24 November 2022
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	===Lung histology===		===Lung histology===
	====~~Cells~~====		====Bronchial cells====
			*Ciliated pseudostratified epithelium.

			Metaplastic changes:
			*Goblet cells.<ref>{{cite journal \|authors=Rogers DF \|title=The airway goblet cell \|journal=Int J Biochem Cell Biol \|volume=35 \|issue=1 \|pages=1–6 \|date=January 2003 \|pmid=12467641 \|doi=10.1016/s1357-2725(02)00083-3 \|url=}}</ref>
			*Squamous - may precede dysplasia and malignancy.

			====Lung cells====
	Common:		Common:
	*Type I pneumocyte - cover most of the alveolar surface.		*Type I pneumocyte - cover most of the alveolar surface.

Michael at 04:01, 6 January 2017

2017-01-06T04:01:25Z

← Older revision		Revision as of 04:01, 6 January 2017
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	===Extralobar sequestration===		===Extralobar sequestration===
	General:		General:
	*Typically not connected to airway tree/trachea.		*Typically not connected to airway tree/[[trachea]].
	*Blood supply arises from aorta, ''not'' the pulmonary artery.		*Blood supply arises from aorta, ''not'' the pulmonary artery.
	*Mass lesion.		*Mass lesion.

Michael: /* Missed lung biopsy */

2016-01-28T19:00:35Z

Missed lung biopsy

← Older revision		Revision as of 19:00, 28 January 2016
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	Comment:		Comment:
	Deepers were cut (x3). The radiologic findings are noted. A re-biopsy is ~~suggested~~.		Deepers were cut (x3). The radiologic findings are noted. A re-biopsy is recommended.
	</pre>		</pre>

Michael: /* Missed lung biopsy */

2016-01-28T18:59:49Z

Missed lung biopsy

← Older revision		Revision as of 18:59, 28 January 2016
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	<pre>		<pre>
	Submitted as "Lung Mass" (Left Lower Lobe), Core Biopsy:		Submitted as "Lung Mass" (Left Lower Lobe), Core Biopsy:
	- ~~Small~~ cluster of indeterminate cells ~~that are too small to assess~~, see comment.		- Tiny cluster of indeterminate cells insufficient for a diagnosis, see comment.
	- Benign lung parenchyma.		- Benign lung parenchyma.
	- NEGATIVE for definite lesion.		- NEGATIVE for definite lesion.

Michael: /* Missed endobronchial biopsy */

2016-01-28T18:47:41Z

Missed endobronchial biopsy

← Older revision		Revision as of 18:47, 28 January 2016
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	This biopsy does not show neoplastic tissue; however, the biopsy may not be representative		This biopsy does not show neoplastic tissue; however, the biopsy may not be representative
	of the lesion seen.		of the lesion seen.
			</pre>

			====Missed lung biopsy====
			<pre>
			Submitted as "Lung Mass" (Left Lower Lobe), Core Biopsy:
			- Small cluster of indeterminate cells that are too small to assess, see comment.
			- Benign lung parenchyma.
			- NEGATIVE for definite lesion.

			Comment:
			Deepers were cut (x3). The radiologic findings are noted. A re-biopsy is suggested.
	</pre>		</pre>

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	CK20 negative, CDX2 negative, beta-catenin membranous staining).		CK20 negative, CDX2 negative, beta-catenin membranous staining).
	</pre>		</pre>

	=Pathology terminology=		=Pathology terminology=
	*Siderophages = mononuclear phagocyte with hemosiderin.<ref>http://medical-dictionary.thefreedictionary.com/siderophore</ref>		*Siderophages = mononuclear phagocyte with hemosiderin.<ref>http://medical-dictionary.thefreedictionary.com/siderophore</ref>

Michael at 03:27, 14 January 2016

2016-01-14T03:27:24Z

← Older revision		Revision as of 03:27, 14 January 2016
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			[[Image:Benign bronchial epithelium and lung parenchyma -- intermed mag.jpg\|thumb\|right\|350px\|Lung parenchyma (left) and bronchial epithelium (right) on a biopsy. [[H&E stain]]. (WC)]]
	This article introduces '''pulmonary pathology''' and discusses an approach to lung specimens.		This article introduces '''pulmonary pathology''' and discusses an approach to lung specimens.

Michael at 03:24, 14 January 2016

2016-01-14T03:24:33Z

← Older revision		Revision as of 03:24, 14 January 2016
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	*Inadequacy rate for percutaneous biopsies ~5% in one series.<ref name=pmid22977650>{{Cite journal \| last1 = McSweeney \| first1 = SE. \| last2 = O'Regan \| first2 = KN. \| last3 = Mc Laughlin \| first3 = PD. \| last4 = Crush \| first4 = L. \| last5 = Maher \| first5 = MM. \| title = Evaluation of the efficacy and safety of percutaneous biopsy of lung. \| journal = Open Respir Med J \| volume = 6 \| issue = \| pages = 82-8 \| month = \| year = 2012 \| doi = 10.2174/1874306401206010082 \| PMID = 22977650 }}</ref>		*Inadequacy rate for percutaneous biopsies ~5% in one series.<ref name=pmid22977650>{{Cite journal \| last1 = McSweeney \| first1 = SE. \| last2 = O'Regan \| first2 = KN. \| last3 = Mc Laughlin \| first3 = PD. \| last4 = Crush \| first4 = L. \| last5 = Maher \| first5 = MM. \| title = Evaluation of the efficacy and safety of percutaneous biopsy of lung. \| journal = Open Respir Med J \| volume = 6 \| issue = \| pages = 82-8 \| month = \| year = 2012 \| doi = 10.2174/1874306401206010082 \| PMID = 22977650 }}</ref>
	*Length 0.5-1.5 cm enough for EGFR testing.<ref name=pmid22006985>{{Cite journal \| last1 = Zhuang \| first1 = YP. \| last2 = Wang \| first2 = HY. \| last3 = Shi \| first3 = MQ. \| last4 = Zhang \| first4 = J. \| last5 = Feng \| first5 = Y. \| title = Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer. \| journal = Acta Radiol \| volume = 52 \| issue = 10 \| pages = 1083-7 \| month = Dec \| year = 2011 \| doi = 10.1258/ar.2011.110150 \| PMID = 22006985 }}</ref>		*Length 0.5-1.5 cm enough for EGFR testing.<ref name=pmid22006985>{{Cite journal \| last1 = Zhuang \| first1 = YP. \| last2 = Wang \| first2 = HY. \| last3 = Shi \| first3 = MQ. \| last4 = Zhang \| first4 = J. \| last5 = Feng \| first5 = Y. \| title = Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer. \| journal = Acta Radiol \| volume = 52 \| issue = 10 \| pages = 1083-7 \| month = Dec \| year = 2011 \| doi = 10.1258/ar.2011.110150 \| PMID = 22006985 }}</ref>

	~~===Sign out===~~
	~~====Missed endobronchial biopsy====~~
	~~<pre>~~
	~~RIGHT UPPER LOBE, ENDOBRONCHIAL BIOPSY:~~
	~~- SMALL FRAGMENT OF BENIGN BRONCHIAL MUCOSA WITH INFLAMMATION.~~

	~~COMMENT:~~
	~~The clinical history of a mass is noted.~~

	~~This biopsy does not show neoplastic tissue; however, the biopsy may not be representative~~
	~~of the lesion seen.~~
	~~</pre>~~

	~~=====Alternate=====~~
	~~<pre>~~
	~~Lung, Left Lower Lobe, Endobronchial Biopsy:~~
	~~- Respiratory bronchiolitis.~~
	~~- Benign bronchial epithelium.~~
	~~- NEGATIVE for granulomatous inflammation.~~
	~~- NEGATIVE for evidence of mass lesion.~~

	~~Comment:~~
	~~Immunostains were done and compatible with bronchial epithelium (napsin negative,~~
	~~TTF-1 negative, CK7 positive, CK20 negative, CDX2 negative, beta-catenin membranous~~
	~~staining) and lung parenchyma (napsin positive, TTF-1 positive, CK7 positive,~~
	~~CK20 negative, CDX2 negative, beta-catenin membranous staining).~~
	~~</pre>~~

	=Basic approach=		=Basic approach=
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	=Normal lung=		=Normal lung=
	:''Benign lung'' redirects here.		:''Benign lung'' redirects here.
	==Lung anatomy==		===Lung anatomy===
	===Airway===		====Airway====
	*Bronchus = has cartilage.		*Bronchus = has cartilage.
	*Bronchiole = non-cartilaginous airway.		*Bronchiole = non-cartilaginous airway.

	===Pleura===		=====Small airways=====
			The trip to the alveolus:<ref>Hegele. 27 October 2009.</ref>
			#Membranous bronchiole.
			#Terminal bronchiole - dilation distal to this = emphysema.
			#Respiratory bronchiole.
			#Alveolar duct - dilated in [[ARDS]].
			#Alveolus.

			====Pleura====
	*Visceral pleura = covers the lung.<ref>URL: [http://www.ouhsc.edu/histology/Glass%20slides/14_15.jpg http://www.ouhsc.edu/histology/Glass%20slides/14_15.jpg]. Accessed on: 10 October 2012.</ref>		*Visceral pleura = covers the lung.<ref>URL: [http://www.ouhsc.edu/histology/Glass%20slides/14_15.jpg http://www.ouhsc.edu/histology/Glass%20slides/14_15.jpg]. Accessed on: 10 October 2012.</ref>
	*Parietal pleura = covers the chest wall.		*Parietal pleura = covers the chest wall.
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	*[[Pleural invasion]] is an important prognosticator in lung cancer and should be considered if the tumour is close to the pleura.		*[[Pleural invasion]] is an important prognosticator in lung cancer and should be considered if the tumour is close to the pleura.

	===Lung lobule===		====Lung lobule====
	Lung lobule:<ref>[http://lib.hku.hk/denlib/exhibition/rarebook/mouth_hygiene_plate.jpg http://lib.hku.hk/denlib/exhibition/rarebook/mouth_hygiene_plate.jpg]</ref>		Lung lobule:<ref>[http://lib.hku.hk/denlib/exhibition/rarebook/mouth_hygiene_plate.jpg http://lib.hku.hk/denlib/exhibition/rarebook/mouth_hygiene_plate.jpg]</ref>
	*Arterial vessels travels with the bronchus.		*Arterial vessels travels with the bronchus.
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	*'''A'''rteries (which were once thought to contain air) are with the '''a'''irway.		*'''A'''rteries (which were once thought to contain air) are with the '''a'''irway.

	==Lung histology==		===Lung histology===
	===Cells===		====Cells====
	Common:		Common:
	*Type I pneumocyte - cover most of the alveolar surface.		*Type I pneumocyte - cover most of the alveolar surface.
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	***Synaptic vesicle 2.		***Synaptic vesicle 2.

	====Images====		=====Images=====
	<gallery>		<gallery>
	Image: Benign bronchial epithelium -- low mag.jpg \| BBE - low mag. (WC)		Image: Benign bronchial epithelium -- low mag.jpg \| BBE - low mag. (WC)
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	*[http://www.proteinatlas.org/dictionary/normal/lung/detail+1/magnification+1 Pneumocytes (proteinatlas.org)].		*[http://www.proteinatlas.org/dictionary/normal/lung/detail+1/magnification+1 Pneumocytes (proteinatlas.org)].

	===~~Small airways~~===		===Sign out===
	~~The trip to the alveolus:~~<~~ref~~>~~Hegele~~. ~~27 October 2009~~.</~~ref~~>		====Missed endobronchial biopsy====
	~~#Membranous bronchiole.~~		<pre>
	~~#Terminal bronchiole~~ - ~~dilation distal to this = emphysema~~.		RIGHT UPPER LOBE, ENDOBRONCHIAL BIOPSY:
	~~#Respiratory bronchiole~~.		- SMALL FRAGMENT OF BENIGN BRONCHIAL MUCOSA WITH INFLAMMATION.
	~~#Alveolar duct~~ - ~~dilated in [[ARDS]]~~.
	~~#Alveolus~~.		COMMENT:
			The clinical history of a mass is noted.

			This biopsy does not show neoplastic tissue; however, the biopsy may not be representative
			of the lesion seen.
			</pre>

			=====Alternate=====
			<pre>
			Lung, Left Lower Lobe, Endobronchial Biopsy:
			- Respiratory bronchiolitis.
			- Benign bronchial epithelium.
			- NEGATIVE for granulomatous inflammation.
			- NEGATIVE for evidence of mass lesion.

			Comment:
			Immunostains were done and compatible with bronchial epithelium (napsin negative,
			TTF-1 negative, CK7 positive, CK20 negative, CDX2 negative, beta-catenin membranous
			staining) and lung parenchyma (napsin positive, TTF-1 positive, CK7 positive,
			CK20 negative, CDX2 negative, beta-catenin membranous staining).
			</pre>
	=Pathology terminology=		=Pathology terminology=
	*Siderophages = mononuclear phagocyte with hemosiderin.<ref>http://medical-dictionary.thefreedictionary.com/siderophore</ref>		*Siderophages = mononuclear phagocyte with hemosiderin.<ref>http://medical-dictionary.thefreedictionary.com/siderophore</ref>

Michael: /* Image */

2016-01-14T03:21:39Z

Image

← Older revision		Revision as of 03:21, 14 January 2016
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	***Synaptic vesicle 2.		***Synaptic vesicle 2.

	====~~Image~~====		====Images====
			<gallery>
	Image: Benign bronchial epithelium -- low mag.jpg \| BBE - low mag. (WC)		Image: Benign bronchial epithelium -- low mag.jpg \| BBE - low mag. (WC)
	Image: Benign bronchial epithelium -- intermed mag.jpg \| BBE - intermed. mag. (WC)		Image: Benign bronchial epithelium -- intermed mag.jpg \| BBE - intermed. mag. (WC)