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Sunday, September 05 2010 @ 10:17 PM CDT

Respiratory System
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The diagnostic feature of PLCH is proliferation of Langerhans cells. These modified macrophages are immunoreactive for S-100 protein and CD1a and contain Birbeck granules at an ultrastructural level. Immunohistochemical and electron microscopic studies of various pulmonary specimens have revealed that the presence of Langerhans cells is not limited to PLCH.Langerhans cells can reside in adenocarcinomas, squamous cell carcinomas, normal lung and various inflammatory and fibrosing conditions, e.g., idiopathic pulmonary fibrosis, and hypersensitivity pneumonia. In these conditions the role of Langerhans cells is unknown, but they may have an immunologic function, such as antigen processing, and presentation to T lymphocytes. The etiology and pathogenesis of PLCH are poorly understood. However, a strong association exists between PLCH and cigarette smoking. Furthermore, cigarette smoking is associated with a significant increase in the number of Langerhans cells present in the pulmonary parenchyma.
Pulmonary Langerhans Cell Histiocytosis
Friday, May 08 2009 @ 11:39 AM CDT
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Lymphoepithelioma-like carcinoma (LELC) is a rare form of lung cancer that has been recently recognized as a subtype of large cell carcinoma of the lung. There are two histologic patterns. The first one (Regaud type) displays well-defined epithelial nests of cells in a syncytial growth pattern surrounded by a heavy lymphoplasmacytic infiltrate. The second pattern is characterized by tumor cells growing in a diffuse manner intermixed, with lymphocytes and plasma cells, mimicking malignant lymphoma (Schmincke type). Histologically 81% of LELC were Regaud type and 9% were Schmincke type. Histopathologic findings: The tumor cells were characterized by ill-defined borders with scanty eosinophilic cytoplasm; round, ovoid, or spindle-shaped nuclei; vesicular chromatin; and one or two distinct eosinophilic nucleoli. High mitotic rates ranging from 3 to 30 mitoses per 10 high power fields were usually found (mean 10 m/hpf). The inflammatory infiltrate in all the cases were moderate to severe and was usually composed by lymphocytes and plasma cells, with occasional lymphoid follicles.
Lymphoepithelioma-like Carcinoma of the Lung
Friday, May 08 2009 @ 11:03 AM CDT
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The usual interstitial pneumonia is a histologic pattern seen in the clinical setting of diffuse, bilateral interstitial lung disease. The histological changes are often distributed along the subpleural and paraseptal regions, and are characterized by patchy, temporally heterogeneous fibrosis with scattered fibroblastic foci at the edges of dense fibrotic scars that cause remodeling of the lung architecture and microscopic honeycombing. The term UIP has been used in two major ways to: as a pathological pattern and as a clinicopathologic syndrome. As an idiopathic clinicopathologic syndrome, UIP is synonymous with idiopathic pulmonary fibrosis. However, the U I P histologic pattern occurs in a variety of clinical settings including collagen vascular disease. If other known causes of diffuse pulmonary lung disease such as drug toxicity, environmental exposures, and collagen vascular diseases have been excluded, the clinicopathologic term idiopathic pulmonary fibrosis is appropriate.
Usual interstitial pneumonia
Tuesday, April 28 2009 @ 11:57 AM CDT
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DIP is thought to represent part of a spectrum of cigarette smoking related lung disease. However, it is thought to have sufficient distinctive clinical, radiographic and histologic features to retain it as a separate category of IIP. Clinical features: DIP usually presents in the 4th or 5th decades of life and it is more common in men than in women by a ratio of 2:1. Virtually all patients are cigarette smokers. The DIP pattern is characterized by diffuse involvement of the lung by numerous macrophage accumulations within most of the distal air spaces. The alveolar septa are thickened by a sparse inflammatory infiltrate that often includes plasma cells and occasional eosinophils, and they are lined by plump cuboidal pneumocytes.The intraluminal macrophages in DIP frequently contain dusty brown pigment ,
Desquamative Interstitial Pneumonia
Tuesday, April 28 2009 @ 11:57 AM CDT
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Acute interstitial pneumonia is a relatively rare form of interstitial pneumonia, since the vast majority of these diseases are chronic. It corresponds to the lesion described by Hamman and Rich in 1944 and subsequently termed Hamman-Rich disease. Another name in the clinical literature is accelerated interstitial pneumonitis, and it would also correspond to cases of adult respiratory distress syndrome (ARDS) in which there are no known predisposing factors (idiopathic ARDS).Mortality rates are very high, approaching 80 to 90% in some series. Those few patients who survive, however, recover pulmonary function almost completely. The histologic hallmark of acute interstitial pneumonia is marked thickening of alveolar sepia due in part to a combination of edema, inflammatory cell infiltration, fibroblast proliferation, and alveolar epithelial hyperplasia. Another factor contributing to the interstitial abnormality is the collapse of alveolar spaces with apposition of adjacent alveolar septa. Many resultant alveolar spaces appear small and slit-like due to the collapse. Hyaline membranes may also be seen along alveolar septa, but they are usually focal and overshadowed by the alveolar septet fibrosis. Thrombi are common in small arteries and are thought to result from in situ thrombosis secondary to endothelial damage. There may be squamous metaplasia with significant cytologic atypia in bronchiolar epithelium.
Acute Interstitial Pneumonia
Tuesday, April 28 2009 @ 11:43 AM CDT
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In 1973, Harwood and associates reported a form of carcinoma in which there was diffuse involvement of pleura, simulating mesothelioma. They termed this tumor pseudomesotheliomatous carcinoma (PsM Ca). They further suggested that this neoplasm, which often showed only pleural thickening without an obvious pulmonary mass, was actually a bronchioloalveolar carcinoma in which the original tumor, being subpleural, was incorporated within the thickened pleura and therefore inapparent. Microscopically, in most cases, malignant glands infiltrate a fibrotic, thickened pleura. Squamous cell differentiation is typically not seen. Neoplastic cells may be seen in the subjacent lung, lining alveolar walls in the manner of bronchioloalveolar carcinoma, but the finding of intrapulmonary tumor is dependent on sampling.
Pseudomesotheliomatous Carcinoma
Tuesday, April 28 2009 @ 11:17 AM CDT
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1) bronchiolocentric cellular interstitial pneumonia, 2) non-caseating granulomas, and 3) intraluminal budding fibrosis, also called organizing pneumonia or Masson bodies. Eosinophils are irrelevant. Fibrosis may be present late. The most consistent histologic feature of HP is the bronchiolocentric cellular interstitial inflammation. Subtle cases usually require careful clinical correlation and the diagnosis may remain tentative.
Hypersentivity pneumonitis
Tuesday, April 28 2009 @ 11:17 AM CDT
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SCLC exhibits aggressive behavior, with rapid growth, early spread to distant sites, exquisite sensitivity to chemotherapy and radiation, and frequent association with distinct paraneoplastic syndromes. HISTOPATHOLOGY: - The tumor is composed of sheets
Small ("Oat") Cell Carcinoma of the Lung
Saturday, August 02 2008 @ 05:05 PM CDT
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Of the three main types of this disease, epithelioid mesothelioma has the best prognosis of all.Currently, there are three forms of epithelial mesothelioma: the most common, pleural mesothelioma; the second most common, peritoneal mesothelioma and the lea
Epithelioid Mesothelioma
Saturday, August 02 2008 @ 05:05 PM CDT
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Large Cell Lung Carcinoma
Saturday, August 02 2008 @ 05:05 PM CDT
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Hyalinizing granulomas occur in middle-aged persons and are frequently mistaken for metastatic carcinoma radiographically. PHG are usually multiple distinct fibrosing nodules, having central whorled deposits of lamellar collagen. The etiology and pathogen
Pulmonary Hyalinizing Granuloma
Saturday, August 02 2008 @ 05:05 PM CDT
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Pulmonary capillary hemangiomatosis is a rare disorder characterized by a proliferation of capillaries that invade the pulmonary interstitium and alveolar septae. Histopathological examination reveals: multifocal proliferation of capillaries in the alveol
Pulmonary Capillary Hemangiomatosis
Saturday, August 02 2008 @ 05:05 PM CDT
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