Pathology of lung, upper airways and pleura

Chronic bronchitis

• complications
• pulmonary hypertension
• respiratory failure
• recurrent infections
• ? bronchogenic carcinoma

Bronchiectasis

• = permanent bronchial / bronchiolar dilation due to wall components destruction
• persistent cough + mucopurulent / fetid sputum
• 1. bronchial obstruction
• tumors, foreign bodies, mucous plugs
• 2. congenital conditions
• cystic fibrosis, Kartagener syndrome
• 3. supurative / necrotizing pneumonias
• Staphylococcus aureus
• Klebsiella spp.

Bronchiectasis

• obstruction + chronic infection  wall damage  wall weakening  wall dilation
• grossly - dilated distal bronchi / bronchioles + pus
• microscopically
• surface ulcerations + mixed inflammation
• peribronchial fibrosis
• complications:
• lung abscess
• obstructive ventilatory defects
• metastatic brain abscess
• AA amyloidosis

Summary

• 1. Atelectasis
• 2. Obstructive lung diseases
• 3. Restrictive lung diseases
• 4. Vascular lung diseases
• 5. Pulmonary infections
• 6. Lung tumors
• 7. Pleural lesions
• 8. Lesions of upper RT

Restrictive lung diseases

• reduced expansion of lung parenchyma
•   FVC x FEV1 normal
• 1. extra-pulmonary disorders
• severe obesity, kyphoscoliosis, neuromuscular diseases
• 2. interstitial lung disorders
• acute
• acute respiratory distress sydrome (ARDS)
• chronic
• pneumoconioses
• sarcoidosis
• idiopathic pulmonary fibrosis
• hypersensitivity pneumonitis

Acute respiratory distress syndrome (ARDS)

• = acute dyspnea onset + hypoxemia + RTG bilateral infiltrates + NO left-sided HF
• = diffuse alveolar damage (DAD)
• direct lung injury
• pneumonia - viral
• aspiration
• pulmonary contusion, inhalation injury
• indirect lung injury
• sepsis, shock – „shock lung“
• uremia
• drug overdose (cytostatics)