Pathology of lung, upper airways and pleura

Bronchogenic carcinoma

• local spread
• lungs, mediastinum
• pericardium, pleura
• lymphatic nodes
• hilar, mediastinal, paratracheal
• distant metastases
• liver, brain, adrenals, bone
• !!! poor prognosis: 5-year survival 14% !!!
• biologic therapy – TKIs of EGFR and of ALK

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

Pleural effusion

• 1. hydrothorax – transudate
• congestive heart failure
• 2. pleuritis + exudate
• pulmonary infections + TBC
• neoplasms (lung, mesothelioma)
• pulmonary infarction
• viral pleuritis
• complications
• suppurative, fibrinous pleuritis  organization  adhesions + calcification

Other pleural conditions

• 3. pneumothorax – air in pleural sac
• lung disease (emphysema, abscess, carcinoma)
• thoracic wall injury (rib fracture)
• complications
• mediastinum shift + lung compression
• 4. hemothorax – blood in pleural sac
• thoracic aorta aneurysm rupture
• 5. chylothorax – lymph in pleural sac
• obstruction of lymphatic ducts (mediastinal neoplasms)

Mesothelioma

• rare malignant tumor of mesothelial cells
• asbestos exposure + long latent period
• grossly
• lung ensheathed by yellow-white firm / gelatinous mass + pleural obliteration
• invasion into lung + thoracic wall
• microscopically
• epithelial + sarcomatoid + biphasic
• poor prognosis

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