Pathology of lung, upper airways and pleura

Sarcoidosis - distribution

• hilar LN (75-90%)
• lungs (90%)
• around bronchioles + venules + subpleural
• skin (25%)
• erythema nodosum (legs)
• lupus pernio (nose, cheeks, lips)
• eye + lacrimal glands (20-50%)
• iridocyclitis, retinitis, optic nerve involvement
• salivary glands (10%)
• xerostomia
• spleen + liver + bone marrow

Sarcoidosis – clinical course

• asymptomatic
• respiratory symptoms
• dyspnea, cough, …
• constitutional signs
• fever, fatique, weight loss…
• uveoparotid involvement = Heerfordt syndrome
• prognosis – unpredictable
• 70% - complete recovery
• 20% - lung dysfunction + visual impairment
• 10% progressive pulmonary fibrosis + cor pulmonale

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

Pulmonary hypertension

• primary hypertension
• plexiform pulmonary arteriopathy
• pulmonary venoocclusive disease
• secondary hypertension
• cardiac disease – L-to-R shunts, mitral stenosis
• lung diseases
• chronic obstructive and restrictive diseases
• recurrent thrombembolism

Pulmonary hypertension - morphology

• 1. main elastic arteries
• atheromas ~ ATH
• 2. medium-sized muscular aa.
• myointimal cells proliferation  lumen narrowing
• 3. arterioles
• medial hypertrophy / thickening
• plexiform lesions, fibrinoid necroses

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