General Pathology

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General Pathology

• Basic Principles of Cellular and Organ Pathology
• Exogenous Pigments

Jaroslava Dušková Inst. Pathol. ,1st Med.
Faculty, Charles Univ. Prague
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Pigments

• Definition
• colored substances
• in the organism
• or environment

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Pigments

• Classification
• endogenous
• hemoproteins derived
• autogenous
• exogenous

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Exogenous Pigments

• - colored substances entering the organism via
• traumatic lesions
• gastrointestinal tract
• respiratory tract

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Exogenous Pigmentation

• traumatic origin
• tatuatio traumatica, arteficialis
• gastrointestinal tract
• intoxicatio Pb, Ag, Au, Fe (!)

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Exogenous Pigmentation

• traumatic origin
• tatuatio traumatica, arteficialis
• mechanic instilation of inert dyes
• (china ink)
• into the deep dermis

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Tatuatio arteficialis - therapy

• LASER Light Amplification by Stimulated
  Emission of Radiation
• low performance laser biostimulation
• high performance laser destruction of
  pigmentation shifts postinflammatory, melasma,
  tatoo
• SURGERY / CRYOSURGERY
• COMBINATION
• COVER UP

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Tatoo

• inert persistent
• macrophage degraded
• macrophage transported
• secondary lymph node pigmentation

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Exogenous Pigmentation

• gastrointestinal tract
• intoxicatio Pb, Ag, Au, Fe (!)

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Exogenous Pigmentation through Airways

• PNEUMOCONIOSES
• Def.
• conditions or diseases elicited with dust
  particles inhalation (lt5?)

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Pneumoconioses

• coniosis simplex
• (anthracosis, siderosis)
• coniofibrosis
• (silicosis, asbestosis,
• coal workers disease, siderosis)
• coniotoxicosis ? conioalergosis
• (byssinosis, berylliosis)

organic dusts
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Anthracosis

• Def.
• pneumoconiosis caused by inert coal-like dust
• (without quartz admixture)
• no symptoms coniosis simplex
• 100 population prevalence

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Silicosis

• Def.
• pneumoconiosis caused by quartz dust with
  pronounced fibrosis response
• CONIOFIBROSIS
• long lasting exposition (2040 years)
• progression even after exposure
  elimination
• part of miners disease
• affinity to other lung diseases (tbc)

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Silicosis

• Stages
• diffuse reticular fibrosis (often clinically
  silent)
• silicotic nodules ( perifocal emphysema)
• massive fibrosis

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Silicosis

• Pathogenesis
• toxic activity of quartz dust to macrophages
• production of PDGF1, IGF-1, fibronectin
• chemotaxins, IL-8
• enzyme activation,
• lung injury, inflammation,
• FIBROSIS

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Silicosis

• Complications
• pulmonary fibrosis
• pulmonary hypertension
• cor pulmonale
• Cause of death
• cardiorespiratory insuffitiency

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Coal Workers Pneumoconiosis - CWP

• Coal macules- dust laden macrophages
• Coal nodules mild collagen admixture
• Advanced
• Combined silicosis anthracosis
• complicated often with tbc

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Asbestosis

• Def.
• pneumoconiosis caused by Asbestos fibrils with
  pronounced fibrotising response
• CONIOFIBROSIS
• Asbestos
• fibrillar mineral with various forms and
  fibrogenic capacity
• chrysotile (90), amosite, croccydolite
  etc.

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Asbestosis

• Pathogenesis
• toxic influence due to fibrils size and
  concentration
• fibrosis with feruginous bodies
• hyalin pleural plaques
• risk of mesotelioma and lung carcinoma
• pleural effusions (mesot. in situ Bedrosjan
  2004)
• other neoplasiae?

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Pneumoconioses

• coniosis simplex
• (anthracosis, siderosis)
• coniofibrosis
• (silicosis, asbestosis,
• coal workers disease, siderosis)
• ---------------------
• coniotoxicosis ? conioalergosis
• (byssinosis, berylliosis,.)

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Coniotoxicosis ? Conioalergosis

• Berylliosis
• acute - toxic pneumonitis
• chronic non caseating granulomas
• Byssinosis cotton dust
• Farmers lung moldy hay, actinomycetes,
• Bird fanciers disease - bird dust