eman_shalabi

Eman Muhammad Salah El-Deen Muhammad Shalabi

Professor - Professor Emeritus of Pathology

Faculty of medicine

Address: القوصية - محافظة أسيوط

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Diseases of the Lung and Pleura for Postgraduates of Pathology, Pediatrics, and Chest Diseases and Tuberculosis

2018-09-30 13:13:30 |

THE LUNG

NORMAL STRUCTURE OF THE LUNG

ANATOMY

HISTOLOGY

FUNCTIONS

DISEASES OF THE LUNG AND PLEURA

Congenital Anomalies of the Lung

Developmental defects of the lung

Pulmonary hypoplasia

Cystic Diseases of the Lung

Congenital cystic disease

Congenital lobar emphysema

Cystic adenomatoid transformation

Foregut cysts

Acquired cystic lung diseases

Mesenchymal cystic hamartoma

Bronchopulmonary Sequestration

Ehlers–Danlos syndromes (EDS)

 Honeycomb lung

ACUTE LUNG DISEASES

ACUTE LUNG INJURY

ACUTE RESPIRATORY DISTRESS SYNDROME
(HYALINE MEMBRANE DISEASE)

Definition

Histological manifestation of ARDS

Forms of ARDS

Neonatal ARDS

Etiology

Pathogenesis of Neonatal ARDS

Adult ARDS

Etiology

Pathogenesis of Adult ARDS

Morphology of ARD

Grossly

Microscopically

BRONCHOPULMONARY DYSPLASIA

Definition

Microscopically

Clinical Features & Consequences of ARDS

Desquamative Interstitial Pneumonia (DIP)

Acute interstitial pneumonitis, diffuse fibrosing alveolitis or Hamman–Rich syndrome

Diffuse fibrosing alveolitis, or acute interstitial pneumonitis

Clinically

ATELECTASIS (COLLAPSE)

Acute atelectasis

Resorption atelectasis

Compression (relaxation) atelectasis

Basal atelectasis

Contraction atelectasis

Chronic atelectasis

Right middle lobe syndrome

Rounded atelectasis

Pulmonary Infections

PNEUMONIA & PNEUMONITIS

Definition

Risk factors

Types of PNEUMONITIS/ PNEUMONIA

Pneumoniitis are classified according to

Onset and duration

Acute pneumonitis/pneumonia

Chronic pneumonitis/pneumonia

Morphological types

Lobar pneumonitis/pneumonia

Lobular/Broncho-pneumonitis/pneumonia

Interstitial pneumonitis/pneumonia

Etiological types

Infective pneumonitis/pneumonia

Bacterial pneumonia

Viral pneumonia

Fungal pneumonia

Protozoal pneumonia

Tuberculous pneumonia

Non-infective pneumonitis

Toxins-induced pneumonitis

Chemical pneumonitis

Aspiration pneumonitis

Auto-immune disease associated pneumonitis

Clinical types

Primary/ secondary pneumonitis/pneumonia depending on the mode of infection

Typical/ atypical pneumonitis/pneumonia depending on the presenting symptoms

Community acquired/ hospital acquired pneumonitis/pneumonia depending on where it was acquired

Pneumonitis/pneumonia in immuno-compromised patients

Currently, combined clinical classification put pneumonia in seven distinct clinical settings pneumonia syndrome

Pneumonia Syndromes

Community-Acquired Acute Pneumonia (CAP)

Health Care-Associated Pneumonia

Hospital-Acquired Pneumonia

Aspiration Pneumonia

Chronic Pneumonia

Necrotizing Pneumonia and Lung Abscess

Pneumonia in Immunocompromised Host

Community-Acquired Bacterial Pneumonias (CAP)

Pneumococcal Pneumonia

Hemophilus influenzae pneumonia

Moraxella catarrhalis pneumonia

Staphylococcus aureus pneumonia

Klebsiella pneumoniae pneumonia

Pseudomonas aeruginosa pneumonia

Legionella pneumophila pneumonia

MORPHOLOGY OF BACTERIAL PNEUMONIA

CLINICAL COURSE OF BACTERIAL PNEUMONIA

COMPLICATIONS OF BACTERIAL PNEUMONIA

Lobar pneumonia

Definition

Etiology of lobar pneumonia

Morphology of lobar pneumonia

Stage of congestion (initial phase

Clinically

Grossly

Microscopic

It is characterized by

Stage of red hepatization (early consolidation)

Gross examination

Microscopic picture

Stage of gray hepatization (late consolidation)

Grossly

Histologically

Stage of resolution (final stage)

Grossly

Histologically

Clinical features of lobar pneumonia

Complications of lobar pneumonia

Bronchopneumonia (Lobular Pneumonia)

Definition

Etiology of lobular pneumonia

Morphology of lobular pneumonia

Grossly

Histologically

Clinical features of lobular pneumonia

Complications of lobular pneumonia

Comparison of lobar pneumonia and lobular pneumonia

Community-Acquired Viral Pneumonia

Pathogenesis of viral pneumonia

Severe Acute Respiratory Syndrome (SARS)

Morphology of viral pneumonia

Clinical Course of viral pneumonia

INTERSTITIAL PNEUMONIA/(PRIMARY ATYPICAL PNEUMONIA)

Etiology of Interstitial pneumonia

Morphology of Interstitial pneumonia

Histologically

Clinical features of Interstitial pneumonia

Complications of Interstitial pneumonia

Health Care-Associated Pneumonia (HCAP)

Hospital-Acquired Pneumonia (HAP)

Aspiration pneumonitis/pneumonia

Chronic Pneumonia

PULMONARY TUBERCULOSIS

Histoplasmosis

The clinical presentations

Morphology of Histoplasmosis

Diagnosis of histoplasmosis

Blastomycosis

Morphology of Blastomycosis

Coccidioidomycosis

Morphology of Coccidioidomycosis

Necrotizing pneumonia and Lung Abscess

Lung Abscess

Etiology and Pathogenesis of Lung Abscess

Morphology of Lung Abscess

Clinical Course of Lung Abscess

Complications of Lung Abscess

Pneumonia in the Immunocompromised Host

Lipoid pneumonia

Definition

The exogenous type

The endogenous type

Grossly

Microscopically

Eosinophilic pneumonia

Definition

Clinically

Pulmonary function testing

Indications

Lung volumes

Lung capacities

 

OBSTRUCTIVE VERSUS RESTRICTIVE PULMONARY DISEASES

OBSTRUCTIVE LUNG (AIRWAY) DISEASES

Definition

Etiology

Smoking

Air pollution

Occupational exposures

Genetics

Others

Protease-antiprotease hypothesis

Patho-Physiology of COPD

CHRONIC BRONCHITIS

Definition

ETIOLOGY OF CHRONIC BRONCHITIS

Smoking

Atmospheric pollution

Occupation

Infection

Familial and genetic factors

PATHOGENESIS OF CHRONIC BRONCHITIS

MORPHOLOGY OF CHRONIC BRONCHITIS

Grossly

Histological examination

Chronic bronchiolitis (small airway disease)

Clinical Features of Chronic Bronchitis

EMPHYSEMA

Definition

PATHOGENESIS OF EMPHYSEMA

Types of Emphysema

Mixed (unclassified) emphysema

MORPHOLOGY OF EMPHYSEMA

Grossly

Microscopically

Morphology of Individual Types of Emphysema

Centriacinar (Centrilobular) Emphysema

Grossly

Microscopically

Panacinar (Panlobular) Emphysema

Grossly

Microscopically

Distal Acinar (Paraseptal) Emphysema

Irregular Emphysema (Para-cicatricial Emphysema)

Mixed (Unclassified) Emphysema

Clinical Features of Emphysema

Contrasting Salient Features of ‘Predominant Bronchitis’ and ‘Predominant Emphysema

Comparison of Symptoms for Chronic Bronchitis and Emphysema

Conditions Related to Emphysema

Compensatory emphysema (Compensatory Overinflation)

Senile Hyperinflation (Aging Lung, Senile Emphysema)

Obstructive Overinflation

Infantile lobar emphysema

Unilateral Translucent Lung (Unilateral  Emphysema

Mediastinal (Interstitial) Emphysema

Bullous emphysema

BRONCHIAL ASTHMA

Definition

Atopic, extrinsic, or allergic

Non-atopic, or intrinsic

A third type is a mixed pattern

ETIO-PATHOGENESIS OF BRONCHIAL ASTHMA

The major etiologic factors of asthma are

Types of Asthma

Atopic, extrinsic, or allergic

Non-atopic, intrinsic or idiosyncratic asthma

Drug-Induced Asthma

Contrasting Features of the Two Major Types of Asthma

Mixed type of asthma

MORPHOLOGY OF BRONCHIAL ASTHMA

Grossly

Microscopically

CLINICAL FEATURES OF ASTHMA

BRONCHIECTASIS

Definition

ETIO-PATHOGENESIS OF BRONCHIECTASIS

Bronchial obstruction

Congenital or hereditary conditions

MORPHOLOGY OF BRONCHIECTASIS

Grossly

Cylindrical

Fusiform

Saccular

Varicose

Microscopically

CLINICAL FEATURES OF BRONCHIECTASIS

 

CHRONIC INTERSTITIAL (RESTRICTIVE, INFILTRATIVE) LUNG DISEASES

Definition

Chronic interstitial diseases

The pulmonary interstitium

Major Categories of Chronic Interstitial Lung Disease

Fibrosing

Granulomatous

Eosinophilic

Smoking-Related

With predominant fibrosis

With predominant granulomatous reaction

Immunologic lung diseases

Smoking-associated ILDs

Obstructive versus Restrictive Pulmonary Diseases

Fibrosing Diseases

Idiopathic Pulmonary Fibrosis (IPF)

Pathogenesis of Idiopathic Pulmonary Fibrosis

Morphology of Idiopathic Pulmonary Fibrosis

Grossly

Microscopically

Clinical Features of Idiopathic Pulmonary Fibrosis

Nonspecific Interstitial Pneumonia

Cryptogenic Organizing Pneumonia

Organizing pneumonia

Pulmonary Involvement in Collagen Vascular Diseases

Scleroderma (Progressive Systemic Sclerosis)

Rheumatoid Arthritis

Systemic Lupus Erythematosus (SLE

Sjögren’s Syndrome

Dermatomyositis and Polymyositis

Wegener’s granulomatosis

Microscopically

PNEUMOCONIOSES

Definition

Factors which determine the extent of damage caused by inhaled dusts are

The tissue response to inhaled dust

Pathogenesis of Pneumoconiosis

Classification of Pneumoconiosis

Mineral Dust–Induced Lung Disease

Coal Worker’s Pneumoconiosis (CWP)

Definition

Pathogenesis of Coal Worker’s Pneumoconiosis

Factors have been implicated in this transformation

Morphology of Pneumoconiosis

SIMPLE COAL-WORKERS’ PNEUMOCONIOSIS

Definition

Grossly

Histologically

PROGRESSIVE MASSIVE FIBROSIS; PMF

Definition

Grossly

Histologically

RHEUMATOID PNEUMOCONIOSIS (CAPLAN’S SYNDROME

Histologically

Clinical Features of CWP

Silicosis

Definition

Pathogenesis of Silicosis

Morphology of Silicosis

Grossly

Histologically

Clinical Features of Silicosis

Asbestosis and Asbestos-Related Diseases

Definition

Pathogenesis of Asbestosis

Morphology of Asbestosis

Over-exposure to asbestos is associated with 3 types of lesions

ASBESTOSIS

Grossly

PLEURAL DISEASE

Pleural effusion

Visceral pleural fibrosis

Pleural plaques

Grossly

Microscopically

TUMOURS

Bronchogenic carcinoma

Malignant mesothelioma

Clinical Features of Asbestosis

Drug- and Radiation-Induced Pulmonary Diseases

Radiation pneumonitis

Acute radiation pneumonitis

Chronic radiation pneumonitis

Granulomatous Diseases

Sarcoidosis

Definition

Pathogenesis

Morphology

Grossly

Histologically

Berylliosis

Berylliosis

Beryllium

Acute Berylliosis

Chronic Berylliosis

Clinical Features of Berylliosis

Hypersensitivity Pneumonitis

Etio-pathogenesis

Farmers’ lung

Bagassosis

Byssinosisis

Bird-breeders’ (Bird-fanciers’)

Mushroom-workers’ lung

Malt-workers’ lung

Maple-bark disease

Silo-fillers’

Morphology of Hypersensitivity Pneumonitis

Interstitial non-caseating granulomas

Clinical Features Hypersensitivity Pneumonitis

Pulmonary Eosinophilia

Acute eosinophilic pneumonia with respiratory

Simple pulmonary eosinophilia (Loeffler syndrome

Tropical pulmonary eosinophilia

Secondary chronic pulmonary eosinophilia

Idiopathic chronic eosinophilic pneumonia

Hyper-eosinophilic syndrome

Morphological features

Grossly

Microscopically

Smoking-Related Interstitial Diseases

Desquamative interstitial pneumonia (DIP)

Microscopically

Respiratory bronchiolitis associated ILD

Microscopically

PULMONARY LANGERHANS CELL HISTIOCYTOSIS

Microscopically

 

PULMONARY DISEASES OF VASCULAR ORIGIN

Pulmonary Edema

Definition

Signs and symptoms

Types of Pulmonary Edema

Cardiogenic pulmonary edema

Non-cardiogenic pulmonary edema

Other causes of pulmonary edema

Hypostatic Pneumonia

Pulmonary Hypertension

Definition

Primary (Idiopathic) Pulmonary Hypertension

Etio-Pathogenesis

Secondary Pulmonary Hypertension

Causes

Antecedent heart disease (Passive pulmonary hypertension)

Hyperkinetic (Reactive) pulmonary hypertension (Congenital left to right shunts

Vaso-occlusive pulmonary hypertension

Pathogenesis of Pulmonary Hypertension

Morphology of Pulmonary Hypertension

Arterioles and small pulmonary arteries

Medium-sized muscular pulmonary arteries

Large pulmonary arteries

Clinical Features of Pulmonary Hypertension

Diffuse Alveolar Hemorrhage Syndromes

Good pasture’s Syndrome

Definition

Etio-pathogenesis

Morphology of Goodpasture Syndrome

Grossly

Microscopically

Clinical features of Goodpasture Syndrome

Idiopathic Pulmonary Hemosiderosis

 

DISEASES OF THE PLEURA

Normal Structure

Microscopically

Important primary disorders

Primary intrapleural bacterial infections

Primary neoplasm of the pleura known as malignant mesothelioma

Hydrothorax

An exudate, and pleuritis

Causes of pleural exudate formation

Inflammation of the Pleura

PLEURITIS

Serous, fibrinous, and sero-fibrinous pleuritis

Supprative pleuritis (Empyema)

Hemorrhagic pleuritis

Non-Inflammatory Pleural  Effusions

Hydrothorax

Hemothothorax

Chylothorax

PNEUMOTHORAX

Spontaneous pneumothorax

Traumatic pneumothorax

Therapeutic (artificial) pneumothorax

 


Time Table for Course of Diseases of the Lung and Pleura for Postgraduates
Six Lectures (2) hours each Two Practical settings for Microscopic examination of the available slides (2) hourss each By the end of the course students should learn DISEASES OF THE LUNG AND PLEURA Congenital Anomalies of the Lung ACUTE LUNG DISEASES ACUTE LUNG INJURY ACUTE RESPIRATORY DISTRE... Read more