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MindMap Gallery Pathology-Respiratory Diseases

Pathology-Respiratory Diseases

This is a mind map about pathology-respiratory system diseases, including pneumonia, chronic bronchitis, lung cancer, etc. It’s full of useful information, interested friends can refer to it!

Edited at 2023-11-18 19:34:42

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Pathology-Respiratory Diseases

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Outline

Respiratory diseases

pneumonia

bacterial pneumonia

Lobar pneumonia

definition

Inflammation caused by pneumococcal bacteria and characterized by diffuse fibrin exudation in the alveoli More common in young adults

Involves all or most of the lung lobes

Cause

Pneumococcal types 1, 2, 3, and 7

Type 3 is the most virulent

Pathological changes clinical connections

congestive edema stage

Day 1-2

To the naked eye: The lung lobes are swollen, congested, and dark red.

Microscopically: the capillaries in the alveolar wall are diffusely dilated and congested; there is a large amount of serous fluid exuding in the alveolar cavity, and a small amount of red blood cells, neutrophils and macrophages.

Contact: Chills, high fever, X-ray shows flaky blurry shadows in the lungs

Red liver metamorphosis stage

Day 3-4

To the naked eye: The texture of the lung lobes becomes solid and the cut surface is gray-red, resembling the appearance of a liver.

Microscopically: there are a large number of red blood cells, fiber, and a small amount of neutrophils and macrophages in the alveolar cavity (fibrinitis)

Contact: rust-colored sputum, chest pain, X-ray shows large shadows in the lungs

Gray liver metamorphosis

Day 5-6

To the naked eye: Lung congestion is reduced, gray-white, and solid like liver

Microscopically: the alveolar cavity contains a large amount of cellulose, and there are a large number of neutrophils and a small amount of red blood cells in the fibrous network (fibrinitis and purulent inflammation)

Contact: The sputum changes from rust-colored to thick mucus, and X-ray shows large dense shadows in the lungs

Dissolution and dissipation period

About 7 days, lasting 1-3 weeks

To the naked eye: The texture of the consolidated lung tissue becomes softer

Under the microscope: neutrophil degeneration and necrosis → proteolytic enzyme → cellulose dissolution, the pathogen is engulfed and dissolved

Contact: Body temperature dropped, X-ray showed return to normal

complication

Lung fleshy changes, purulent pleurisy and empyema, lung abscess, sepsis/septic sepsis, septic shock

Lobular pneumonia

definition

Acute purulent inflammation caused by purulent bacteria, with pulmonary lobules as the lesion unit More common in children, the elderly, and those who have been bedridden for a long time

Cause

pneumococci

In severe cases, it involves the large lobes of the lungs and develops into confluent bronchopneumonia, which generally does not involve the pleura.

Pathological changes

Gross eye: mostly in the lower lobes and dorsal side, generally not involving the pleura

Microscopically: early stage—mucosal congestion, edema, and surface mucus exudate coverage; Middle and late stage - neutrophils, a small amount of red blood cells and shed alveolar epithelial cells in the lumen and alveolar space; In severe cases - increased infiltration of neutrophils in the lesion, destruction of bronchial and lung tissue, and complete suppurative inflammation.

complication

Heart failure, respiratory failure, lung abscess and empyema, sepsis, bronchiectasis

the difference

chronic bronchitis

Chronic non-specific inflammatory disease of bronchial mucosa and surrounding tissues

More common in the elderly

Clinical features

Chronic cough, sputum production or wheezing symptoms, lasting for 3 months every year for more than 2 consecutive years

Etiology and pathogenesis

viral and bacterial infections

smoking

Air pollution and allergy factors

intrinsic factors

Pathological changes

The respiratory mucus-ciliary drainage system is damaged and squamous metaplasia occurs

Submucosal glandular hypertrophy and mucinous gland metaplasia of serous epithelium

Congestion and edema of the vessel wall, infiltration of lymphocytes and plasma cells

Smooth muscle rupture and atrophy in the wall, cartilage variability, atrophy or ossification

Bronchiolitis and peribronchiolitis are the underlying causes of chronic obstructive emphysema

clinicopathological link

Cough - inflammation irritates the bronchial tubes

Coughing up phlegm - Coughing up a large amount of white sticky sputum or serous foam, accompanied by bacterial infection and purulent

asthma

lung cancer

Cause

smoking

Air pollution: 3,4-benzopyrene, diethylnitrosamine

Occupational factors: long-term exposure to radioactive substances or inhalation of industrial dust, etc.

Molecular genetic changes: gradual accumulation of genetic abnormalities

Pathological changes

General type

Central type (hilar type)

Occurs in the main bronchus or lobar bronchi, forming a mass in the hilus

60~70%

In the early stage of disease, the tracheal wall may thicken diffusely or form polypoid or papillary tumors protruding into the tracheal lumen, causing the tracheal lumen to be narrowed or occluded.

As the disease progresses, the tumor destroys the tracheal wall, infiltrates into the surrounding lung tissue, expands, and forms a huge mass surrounding the bronchus in the hilum of the lung.

peripheral lung cancer

Originating from the lung segment or its distal bronchi, forming isolated nodular or spherical cancer nodules at the periphery of the lung close to the lung membrane

30~40%

Lymph node metastasis occurs later than in the intermediate type, but can invade the pleura

diffuse lung cancer

Rare, 2~5%

Originating from the peripheral lung tissue, it diffusely infiltrates and grows along the alveolar ducts and alveoli, forming a majority of corn-sized nodules covering part of the large lobes or the entire lung lobes.

Histological type

Adenocarcinoma

The most common type of lung cancer in women, mostly non-smokers

Slow growth, metastasis can occur early

Usually occurs peripherally, subpleurally

squamous cell carcinoma

Middle-aged and elderly men, most of whom have a history of smoking

Mainly occurs in the center of the main bronchus, eventually spreading to local hilar lymph nodes, and spreads outside the chest relatively late

Well differentiated - keratinized beads, intercellular bridges; poorly differentiated - few squamous cell features

neuroendocrine cancer

small cell carcinoma

15%-20%

The highest degree of malignancy, more sensitive to radiotherapy and chemotherapy

The central type is common, occurs in the large bronchi, infiltrates and grows into the lung parenchyma, and forms a huge mass.

Under the microscope, the cancer cells are small, round or oval; or spindle-shaped or oat-shaped, with little cytoplasm like naked nuclei, diffuse distribution or lamellar cord-like arrangement (oat cell carcinoma)

large cell carcinoma

10%

Large cell undifferentiated carcinoma

Cancer cells are solid masses or sheets, large in size, rich in cytoplasm, homogeneous and lightly stained, and mitotic figures are common.

No histological, morphological, or immunophenotypic features of adenocarcinoma, squamous cell carcinoma, or neuroendocrine carcinoma differentiation

The prognosis is poor and there is a tendency to spread to distant places in the early stage.

adenosquamous carcinoma

Squamous cell carcinoma and adenocarcinoma each account for more than 10%

Diffusion pathway

direct diffusion

transfer

lymphatic metastasis

Occurs earlier and spreads faster

Parabronchial, hilar-mediastinal, supraclavicular, axilla, neck

Peripheral type can enter the subpleural lymph node plexus

Hematogenous metastasis

Brain (20%), liver (30-50%), bone (20%), adrenal glands

clinicopathological link

Cough, expectoration with blood, chest pain

Collapse of the lung or emphysema, lung infection

Bloody pleural effusion

Superior vena cava syndrome: facial edema and cervical and thoracic varicose veins

Horner syndrome: compression or erosion of cervical sympathetic nerves and cervical nerve roots → ptosis, miosis of the pupil on the affected side, and no sweat on the skin of the chest wall

carcinoid syndrome

pulmonary silicosis

It is mainly caused by a large amount of silicon-containing dust in the environment, which is deposited in the lungs and generally occurs more among working people.

Cause

SiO2, <5μm, 1-2μm particles are the most pathogenic

Pathogenesis

SiO2 H20 → Silicic acid → Macrophage phagocytosis → Macrophage autolysis → Chronic inflammation → Pulmonary fibrosis Release silica dust (swallowed up again)

Basic lesions

Formation of silica nodules, diffuse fibrosis of lung tissue

Pathological changes

Silicon nodules, diffuse fibrosis of lung tissue

Naked eyes: round or oval nodules, 3-5mm in diameter, gray-white, hard, and gritty. Under the microscope: cellular silica nodules (silica nodules can be seen within cells) → fibrous silica nodules: collagen fibers arranged in concentric circles or swirls (hyalinization may occur); degeneration and degeneration may occur in the center of fused nodules. Necrosis and liquefaction form silicotic cavities, and hilar lymph nodes can also be seen.

Stage I scattered pulmonary nodules, with no obvious fibrosis, in the middle and lower lobes of both lungs near the hilus, due to lymphatic reflux after macrophage phagocytosis (silicone nodules are obvious near the hilar lymph nodes) Stage II has obvious fibrosis, less than 1/3, and the lesions are in the perihilar lung tissue. Stage III diffuse fibrosis＞1/3

Staging: according to the size, number and distribution of silicon nodules

complication

tuberculosis

chronic cor pulmonale

Lung infections and obstructive emphysema

Emphysema

A disease in which peripheral lung tissue (respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli) contains too much air and is accompanied by destruction of alveolar intervals and weakened elasticity of lung tissue, leading to expansion of lung volume and reduced ventilation function.

Cause

The most common is chronic bronchitis

Pathogenesis

Obstructive ventilatory disorders, reduced elasticity of respiratory bronchioles and alveolar walls, reduced a1-antitrypsin levels

type

alveolar emphysema

interstitial emphysema

Other types of emphysema

paracicatric emphysema

Pathological changes

Naked eyes: The lungs are enlarged, gray in color, with blunt edges, soft and lack of elasticity, and the indentation does not fade easily after acupressure.

Microscopically: the alveoli expand, the intervals narrow and break, and adjacent alveoli fuse into larger cysts

clinicopathological link

In addition to coughing and sputum, patients also have symptoms of hypoxia; in severe cases, they develop "barrel chest"