1、department of pathology,The respiratory system disease,department of pathology,Nasopharyngeal carcinoma,Chronic bronchitis,Chronic constructive emphysema,Pneumonia Silicosis Cancer of the lung,Chronic cor pulmonale,department of pathology,Chronic bronchitis,obstructive emphysema,Chronic cor pulmonal
2、e,department of pathology,Chronic bronchitis,obstructive emphysema,Chronic cor pulmonale,department of pathology,Acute bronchitis,department of pathology,Chronic bronchitis - mucous gland proliferation,department of pathology,Chronic bronchitis - inflammatory cell infiltrating,department of patholog
3、y,Chronic bronchitis - squamous metaplasia,department of pathology,Chronic bronchitis,department of pathology,Chronic bronchitis - small airway,department of pathology,Chronic bronchitis - small airway,department of pathology,department of pathology,Chronic bronchitis - small airway,department of pa
4、thology,Chronic bronchitis,obstructive emphysema,Chronic cor pulmonale,department of pathology,department of pathology,emphysema,department of pathology,department of pathology,department of pathology,“Smoking ” lung,department of pathology,emphysema,department of pathology,Chronic bronchitis,Pulmon
5、ary emphysema,department of pathology,department of pathology,capillary vessel pressured capillary vessels decrease,pulmonary hypertension,right ventricular hypertrophy,Cor pulmonale (Pulmonary heart disease),department of pathology,Chronic bronchitis,obstructive emphysema,Chronic cor pulmonale,depa
6、rtment of pathology,Chronic cor pulmonale can be any of the diseasesThe most common cause is chronic obstructive lung disease.,department of pathology,Morphology is characterized by right ventricular, and often right atria, hypertrophy（up to 1cm or more）.The thickness of the right ventricular wall m
7、ay exceed that of the left ventricle.,department of pathology,department of pathology,Cor pulmonale,department of pathology,Cor pulmonale,department of pathology,Diagnosis 5mm,department of pathology,Diagnosis?,department of pathology,Cases:,Discussion and pathological diagnosis,department of pathol
8、ogy,Nasopharyngeal carcinoma,Chronic bronchitis,Chronic constructive emphysema,Pneumonia Silicosis Cancer of the lung,Chronic cor pulmonale,department of pathology,pneumonia,alveolus,interstitium,Lobar pneumonia,Lobular pneumonia,Bacterial pneumonia,viral pneumonia,Fungal pneumonia,department of pat
9、hology,alveolus,Lobar pneumonia,Lobular pneumonia,Bacterial pneumonia,Legionella pneumonia,interstitium(bronchiole),department of pathology,department of pathology,Lobar pneumonia,Etiological factorpneumococci (95%)location (anatomic distribution)lobarBasic changeacute fibrinous inflammation,departm
10、ent of pathology,Clinical featuresadult , sudden malaise, shaking chillsfever ( up to 40 or 41 C )cough, slightly turbid, watery sputum, frankly purulent, hemorrhage, “rusty” sputumshortness of breath, orthopnea, cyanosis,department of pathology,morphology,department of pathology,Four stagesstage of
11、 congestionstage of red hepatizationstage of gray hepatizationstage of resolution,department of pathology,stage of red hepatization,stage of gray hepatization,department of pathology,stage of red hepatization,department of pathology,stage of red hepatization,department of pathology,stage of gray hep
12、atization,department of pathology,stage of gray hepatization,department of pathology,stage of gray hepatization,department of pathology,stage of gray hepatization,department of pathology,Organization of lobar pneumonia,department of pathology,Lobular pneumonia (bronchopneumonia),Etiological factorba
13、cteria ( pyogenic organisms )location (anatomic distribution)lobular( bronchiole + alveolar)Basic changeacute suppurative inflammation,department of pathology,Clinical featureselderly and child, malnutritionfever ( up to 38 or 39.5C )cough, expectoration,department of pathology,morphology,department
14、 of pathology,bronchopneumonia,department of pathology,bronchopneumonia,department of pathology,department of pathology,department of pathology,bronchopneumonia,department of pathology,bronchopneumonia,department of pathology,bronchopneumonia,department of pathology,bronchopneumonia,department of pa
15、thology,bronchopneumonia,department of pathology,department of pathology,interstitial pneumonia ( Primary atypical pneumonia ),Anatomic distributionPulmonary interstitial inflammation Etiologic agent virus and mycoplasm ( the most ),department of pathology,The clinical course is varied depending on
16、the extent and severity of the disease.Histology shows interstitial inflammation consisting of lymphocytes, macrophages and plasma cell.The alveoli may be relatively free of cellular exudate.,department of pathology,morphology,department of pathology,department of pathology,Here is the microscopic a
17、ppearance of a viral pneumonia with interstitial lymphocytic infiltrates. Note that there is no alveolar exudate.,department of pathology,Interstitial pneumonia,department of pathology,Viral pneumonia with hemorrhage,department of pathology,Viral pneumonia,department of pathology,department of patho
18、logy,Mycoplasma pneumonia,department of pathology,Mycoplasma pneumonia,department of pathology,Nasopharyngeal carcinoma,Chronic bronchitis,Chronic constructive emphysema,Pneumonia Silicosis Cancer of the lung,Chronic cor pulmonale,department of pathology,Silicates are inorganic minerals abundant in
19、stone and sand. Any industrial worker involved in the grinding of stone or sand will be at risk from silicosis. Silicosis is the occupational disease.,department of pathology,Etiological factorsilica less than 2m in diametersmall particles enter the terminal respiratory units where they are ingested
20、 by alveolar macrophages,fibrosis + nodules,department of pathology,Basic changediffuse pulmonary fibrosisnumerous silicotic nodules,department of pathology,department of pathology,department of pathology,department of pathology,Diffuse interstitial fibrosis,department of pathology,Diffuse interstit
21、ial fibrosis,department of pathology,Stage stage - silicotic nodules in hilar lymph node stage - silicotic nodules in lungs, changes less than 1/3 lung stage - silicotic nodule more than 2cm,department of pathology,Complications Tuberculosis and silicotuberculosis Chromic cor pulmonale Infection of
22、lung and chromic obstructive emphysema,department of pathology,Nasopharyngeal carcinoma,Chronic bronchitis,Chronic constructive emphysema,Pneumonia Silicosis Cancer of the lung,Chronic cor pulmonale,department of pathology,Nasopharyngeal carcinoma,department of pathology,This carcinoma was one of th
23、e earliest cancers linked to a prior viral infection, Epstein-Barr Virus (EBV). This carcinoma accounts for over 50% of all malignancies in China, but accounts for only 2% of malignancies in the United States.,department of pathology,department of pathology,department of pathology,department of path
24、ology,department of pathology,Histological classificationSquamous cell carcinoma differentiatedundifferentiated Adenocarcinoma,department of pathology,Normal Nasopharyngeal epithelium,department of pathology,Vesicularnucleus carcinoma,department of pathology,Vesicularnucleus carcinoma,department of
25、pathology,Spread and metastasis Direct spreading Lymphatic metastasis Hematogenous metastasis,department of pathology,department of pathology,Primary cancer of the lung,Most common primary malignant tumourDirectly related to cigarette smokingAssociated with occupational exposure to carcinogens Overa
26、ll 5-year survival rate of 4-7%Squamous cell, small cell, adenocarcinoma, and large cell undifferentiated types,department of pathology,morphology,department of pathology,This is a squamous cell carcinoma of the lung that is arising centrally in the lung .,department of pathology,department of patho
27、logy,This tumor arise near the hilus of the lung .,department of pathology,department of pathology,department of pathology,Diffuse type lung carcinoma,Metastasic carcinoma,department of pathology,This is a peripheral adenocarcinoma of the lung. Adenocarcinomas and large cell anaplastic carcinomas te
28、nd to occur more peripherally in lung. The solitary appearance of this neoplasm suggests that the tumor is primary rather than metastatic.,department of pathology,Histological classificationNor small cell lung carcinoma(NSCLC)Squamous cell carcinoma(50-60%)adenocarcinoma(13-15%)Large cell carcinoma(
29、15-20%)Small cell lung carcinoma(SCLC)“oat cell carcinoma”(10-20%),department of pathology,Squamous cell carcinoma of lung,department of pathology,department of pathology,Oat cell carcinoma of lung,department of pathology,Spread and metastasis Direct spreading Lymphatic metastasis Hematogenous metas
30、tasis,department of pathology,This is sqamous cell carcinoma that extends from hilum to pleura.,department of pathology,department of pathology,Lymphatic metastasis,department of pathology,department of pathology,department of pathology,department of pathology,department of pathology,department of p
31、athology,Summarize,department of pathology,Nasopharyngeal carcinoma,Chronic bronchitis,Chronic constructive emphysema,Pneumonia Silicosis Cancer of the lung,Chronic cor pulmonale,department of pathology,Chronic bronchitis,obstructive emphysema,Chronic cor pulmonale,department of pathology,Chronic br
32、onchitis - inflammatory cell infiltrating,department of pathology,“Smoking ” lung,department of pathology,emphysema,department of pathology,Chronic bronchitis,Pulmonary emphysema,department of pathology,capillary vessel pressured capillary vessels decrease,pulmonary hypertension,right ventricular hy
33、pertrophy,Cor pulmonale (Pulmonary heart disease),department of pathology,pneumonia,alveolus,interstitium,Lobar pneumonia,Lobular pneumonia,Bacterial pneumonia,viral pneumonia,Fungal pneumonia,department of pathology,alveolus,Lobar pneumonia,Lobular pneumonia,Bacterial pneumonia,Legionella pneumonia
34、,interstitium(bronchiole),department of pathology,department of pathology,Lobar pneumonia,department of pathology,Etiological factorpneumococci (95%)location (anatomic distribution)lobarBasic changeacute fibrinous inflammation,department of pathology,Clinical featuresadult , sudden malaise, shaking
35、chillsfever ( up to 40 or 41 C )cough, slightly turbid, watery sputum, frankly purulent, hemorrhage, “rusty” sputumshortness of breath, orthopnea, cyanosis,department of pathology,stage of red hepatization,stage of gray hepatization,department of pathology,stage of red hepatization,department of pat
36、hology,stage of gray hepatization,department of pathology,stage of gray hepatization,department of pathology,Organization of lobar pneumonia,department of pathology,Lobular pneumonia (bronchopneumonia),department of pathology,Etiological factorbacteria ( pyogenic organisms )location (anatomic distri
37、bution)lobular( bronchiole + alveolar)Basic changeacute suppurative inflammation,department of pathology,Clinical featureselderly and child, malnutritionfever ( up to 38 or 39.5C )cough, expectoration,department of pathology,bronchopneumonia,department of pathology,bronchopneumonia,department of pat
38、hology,bronchopneumonia,department of pathology,bronchopneumonia,department of pathology,interstitial pneumonia ( Primary atypical pneumonia ),department of pathology,Anatomic distributionPulmonary interstitial inflammation Etiologic agent virus and mycoplasm ( the most ),department of pathology,The
39、 clinical course is varied depending on the extent and severity of the disease.Histology shows interstitial inflammation consisting of lymphocytes, macrophages and plasma cell.The alveoli may be relatively free of cellular exudate.,department of pathology,Here is the microscopic appearance of a vira
40、l pneumonia with interstitial lymphocytic infiltrates. Note that there is no alveolar exudate.,department of pathology,silicosis,department of pathology,Silicates are inorganic minerals abundant in stone and sand. Any industrial worker involved in the grinding of stone or sand will be at risk from s
41、ilicosis. Silicosis is the occupational disease.,department of pathology,Etiological factorsilica less than 2m in diametersmall particles enter the terminal respiratory units where they are ingested by alveolar macrophages,fibrosis + nodules,department of pathology,Basic changediffuse pulmonary fibr
42、osisnumerous silicotic nodules,department of pathology,department of pathology,department of pathology,Diffuse interstitial fibrosis,department of pathology,Stage stage - silicotic nodules in hilar lymph node stage - silicotic nodules in lungs, changes less than 1/3 lung stage - silicotic nodule mor
43、e than 2cm,department of pathology,Complications Tuberculosis and silicotuberculosis Chromic cor pulmonale Infection of lung and chromic obstructive emphysema,department of pathology,Nasopharyngeal carcinoma,department of pathology,This carcinoma was one of the earliest cancers linked to a prior vir
44、al infection, Epstein-Barr Virus (EBV). This carcinoma accounts for over 50% of all malignancies in China, but accounts for only 2% of malignancies in the United States.,department of pathology,department of pathology,department of pathology,department of pathology,Histological classificationSquamou
45、s cell carcinoma differentiatedundifferentiated Adenocarcinoma,department of pathology,Vesicularnucleus carcinoma,department of pathology,Spread and metastasis Direct spreading Lymphatic metastasis Hematogenous metastasis,department of pathology,Primary cancer of the lung,department of pathology,Mos
46、t common primary malignant tumourDirectly related to cigarette smokingAssociated with occupational exposure to carcinogens Overall 5-year survival rate of 4-7%Squamous cell, small cell, adenocarcinoma, and large cell undifferentiated types,department of pathology,department of pathology,department o
47、f pathology,Diffuse type lung carcinoma,Metastasic carcinoma,department of pathology,This is a peripheral adenocarcinoma of the lung. Adenocarcinomas and large cell anaplastic carcinomas tend to occur more peripherally in lung. The solitary appearance of this neoplasm suggests that the tumor is prim
48、ary rather than metastatic.,department of pathology,Histological classificationNor small cell lung carcinoma(NSCLC)Squamous cell carcinoma(50-60%)adenocarcinoma(13-15%)Large cell carcinoma(15-20%)Small cell lung carcinoma(SCLC)“oat cell carcinoma”(10-20%),department of pathology,Squamous cell carcinoma of lung,department of pathology,department of pathology,Oat cell carcinoma of lung,department of pathology,Spread and metastasis Direct spreading Lymphatic metastasis Hematogenous metastasis,department of pathology,This is sqamous cell carcinoma that extends from hilum to pleura.,
