Pathology of lung, upper airways and pleura

Acute respiratory distress syndrome (ARDS)

• epithelium + endothelium injury  alveolar capillary membrane damage   vascular permeability  alveolar flooding + surfactant abnormalities
• grossly
• dark red + firm + airless + heavy lung ~ liver
• microscopically - acute phase
• capillary congestion + alveolar cells necrosis
• interstitial + alveolar edema + hemorrhage
• hyaline membranes (edema fluid + cell debries)

Acute respiratory distress syndrome (ARDS)

• microscopically - proliferative phase
• pneumocytes II proliferation + hyaline membranes phagocytosis (macrophages)
• P II differentiate into pneumocytes I
• interstitial fibroblasts proliferation  interstitial fibrosis = honeycomb lung

Acute respiratory distress syndrome (ARDS)

• clinical course
• !!! mortality 30-40% !!!
• normal respiratory function within 6-12 months
• diffuse interstitial fibrosis

Sudden Infant Death Syndrome

• „sudden death of infant < 1 year + complete autopsy does not reveal other cause of death“
• 1 to 700-1,000 liveborn
• age: 2 - 4 months, boys (2 : 1)
• crib death x night ~ day
• winter (infection – trigger ???)
• mother´s smoking
• autopsy: big thymus + serosal petechiae
• ??? brain stem ganglia abnomalities
• ??? heart conductive system abnormalities

Sarcoidosis

• = multisystemic disease with noncaseating granulomas in many tissues and organs
• etiology – unknown (??? Th lymphocytes)
• younger adults, non-smokers
• familial clustering, Scandinavia
• hypercalcemia + hypercalciuria
• microscopy (dg. of exclusion)
• noncaseating granulomas + specific granulation tissue
• epithelioid + multinucleated cells
• Schaumann bodies + asteroid bodies