Lung Pathology

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Lung - Pathology
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Pulmonary embolism

• Cause Almost always due to emboli from DVT (gt
  95 )
• High risk patients with severe burns, Trauma,
  Fractures, Hypercoagulable states, hospitalized
  pts.
• Clinically
• gt two-thirds of cases of PE are not diagnosed
  before death
• 10 of acute adult in-hospital deaths
• Complications
• Large emboli ? sudden death from respiratory
  failure or acute CHF (acute cor pulmonale)
• Small emboli ? silent or cause pulmonary
  hemorrhage or infarctions
• Multiple small emboli ? pulmonary HTN ? Chronic
  cor-pulmonale.

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Pulmonary emboli
A
B
C
Which one is the MCC? MC in pregnancy? MC after
Fracture of long bones?
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Pulmonary Infarction
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• Pulmonary HTN
• Definition Mean pulmonary pressure 1/4 (30 mm
  Hg) of systemic pressure (normal 1/8th 120/8
  15 mmHg.)
• Causes COPD, interstitial lung disease, Left HF
  , Recurrent PE
• Effects
• Large arteries Atherosclerosis.
  
• Medium small arteries intimal fibrosis
  hypertrophy of musculo -elastic tissue of the
  media
  
• Plexogenic arteriopathy plexus of capillary
  channels within dilated arteries produces a
  web).
• Primary Pulmonary Hypertension
• Rare, idiopathic
• in children or young women (lt 40s)
• Presents as Cor - pulmonale

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Pulmonary HTN
intimal fibrosis hypertrophy of media
Plexogenic arteriopathy
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• Diffuse pulmonary hemorrhage syndromes
• Goodpastures syndrome necrotizing hemorrhagic
  interstitial pneumonitis rapid progressive GN
  (RPGN)
• Seen in young men
• Due to anti-basement membrane antibody (Anti-BM)
• Morphology linear basement membranes deposits of
  immunoglobulins and complement in IF
• Clinically Hemoptysis ? diffuse pulmonary
  fibrosis
• Vasculitis-associated hemorrhage
• Conditions Hypersensitivity angiitis (mPAN),
  Wegners granulomatosis, SLE
• Present with cough, enlargement of mediastinium
• Morphology bleeding and granulomas
• Difficult to treat develop a large necrosis and
  its progressive disease

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Diffuse pulmonary hemorrhage syndromes