Coin lesion considered malignant until proved otherwise

1
Coin lesion -- considered malignant until proved
otherwise
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Hamartoma - benign cartilaginous lesion
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Cannon balls metastatic lesions
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Metastases- irregularly sized and shaped lesions
-- compare to previous CXR
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Squamous cell carcinoma - large, irregular nuclei
with keratin more common men than women, most
arise in bronchi, obstruction is presenting
feature
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Adenocarcinoma -- tall, columnar cells mucin
() women, non-smokers lt40 yoa, associated with
scars, slow growing but metastasize early
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Large cell carcinoma -- aggressive
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Small cell carcinoma- basophilic cells with
areas of necrosis, lymph-like cells (oat cells)
derived from neuro-endocrine cells Associated
with paraneoplastic syndromes
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(No Transcript)
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Small cell carcinoma
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Endobronchial carcinoma This one is too high to
be resected
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A small endobronchial carcinoid (right).
Histologically, there are well-defined nests of
homogeneous cells with uniform nuclei (left).
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Mesothelioma -- related to which type of
asbestos? Amphibole (straight)
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Pleural effusion must tap to determine if
transudate or exudate
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Pneumothorax
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Laryngeal cancer
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Squamous carcinoma -- hyperkeratosis, associated
with alcohol and smoking Presentation persistent
hoarseness
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Mesothelioma -- uniform cells invading pleura
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Pneumocystis carinii hypoxemia, no
infiltrate common in immunosuppressed pts
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Pneumocystis carinii biopsy -- fluffy alveolar
infiltrates
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Lobar pneumonia -- classically what bt? Strep
pneumo
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Lobar pneumonia Stage 3 Gray hepatization -- PMNs
ingesting and destroying RBCs
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Acute bacterial pneumonia -- early red
hepatization with neutrophils
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Bacterial pneumonia -- PMNs in alveoli
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Bronchopneumonia -- common organisms? Strep
pneumo, H flu, Legionella, Pseudomonas
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Legionaires disease
27
Bronchopneumonia -- some normal alveoli,
congestion near bronchi
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Interstitial pneumonia -- lungs look fluffy
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Interstitual pneumonia -- somealveoli filled, few
inflammatory cells
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Interstitial pneumonia -- thickened septa
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Fluorescent stain for Tb
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Acid fast stain for Tuberculosis
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Caseating granuloma -- immune competent pt
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Ghons complex -- primary focus plus regional
lymph node
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Tuberculosis -- reactivation in upper lobes
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Miliary Tb -- disseminated