The document discusses various diseases of the respiratory system, including different types of pneumonia like lobar pneumonia, lobular pneumonia, and interstitial pneumonia. It also discusses other conditions like lung abscesses, pulmonary tuberculosis, pulmonary hypertension, pulmonary bilharziasis, bronchial obstruction, and atelectasis. It provides details on the causes, characteristics, pathological features, and complications of these various respiratory diseases.

1. Prof.Dr.
Khalil Hassan Zenad
Aljeboori
Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Lecture 20
DISEASES OF RESPIRATORY
SYSTEM

2. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Pneumonia or pneumonitis is inflammation of lung tissue, the
common types were:
1.Lobar pneumonia
2.Lobular pneumonia ( bronchopneumonia)
3.Interstitial pneumonia.
Pneumonia:

3. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Caused by Pneumococcus or Streptococcus pneumoniae reach the alveoli
during inhalation or by blood (bacteremia) it involve the whole lobe of lung
with fluid exudates contain blood (stage of engorgement or congestion)
4-12hr. Then fibrin and coagulation of fluid result in consolidated red area in
next 2 days. Known as red hepatization, in the next stage the fibrin and
leukocytes and blood is squeezed out of affected lobe this stage known as
grey hepatization which last for 3rd to 11th day. Then resolution occur is a
final stage, the exudates are removed by lysis and phagocytosis.
Complication: abscess, empyema, pericarditis, endocarditis, meningitis,
peritonitis.
1.Labor pneumonia:

4. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Caused by streptococci, staph, pneumococci, Hemophilus influenza, viruses
and T.B it occur following all upper respiratory tract affection, tonsillitis,
sinusitis, measles, whooping cough…etc. the Streptococcus is usually main
pathogenic organisms cause the suppurative exudates fill the bronchioles
and alveoli, lead to patchy necrosis which result into fibrosis and healing,
the exudates is similar to lobar pneumonia exudates but differ in the
distribution.
Complications:
Gangrene, bronchiectasis, emphysema, pulmonary fibrosis.
2.Lobular pneumonia (bronchopneumonia):

5. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Occur follow measles, influenza virus whooping cough, psittacosis
(Chlamydia) and other infectious agents.
It has a characteristic pneumonic reaction to infectious agent (viruses,
bacteria) and with toxoplasma, Chlamydia,etc.
Grossly is not characteristic but microscopically is the thickening of
alveolar walls, particularly around the bronchi and bronchioles, alveolar
thickening is due to mononuclear cells infiltration, congestion of alveolar
capillaries. Some neutrophils and mononuclear cells may be seen in
alveoli and bronchioles.
3.Interstitial pneumonia:

6. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Rheumatic pneumonia:
inflammation of lung and pleura characterized by proliferation of Aschoff
bodies and fibrosis.
Lung abscess:
Inflammation of lung tissue with suppurative exudates accompanied by destruction of
lung tissue with abscess formation.
Etiology:
Following the:
1. Inhalation group: after tonsillectomy, bacteria inhaled into lung cause
bronchopneumonia and suppuration and abscess formation.
2. Post pneumonic group: following labor pneumonia, bronchopneumonia lead to
abscess formation.
3. Systemic pyemia: septic emboli pass to lung produce infarcts and pulmonary infection
and abscess formation.
4. In bronchiectasis the wall of bronchi completely destroyed with abscess.

7. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
 It develop in lower or middle part of lung in children where as in adult
it is frequent in upper part of lung. The tubercle when spread by
lymphatic to mediastinal lymph node cause enlargement so both
lesion in lung and lymph node termed primary complex in some cases
healing by fibrosis or calcification or dissemination by blood or
lymphatic. In individuals not previously infected may show primary
type of infection, most cases of bovine tuberculous infection occur
from milk, the infection here occur in alimentary tract and mesenteric
lymph node mainly.
Pulmonary tuberculosis: (granulomatous pneumonia):

8. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
 If the lesion progress the caseation necrosis, healing with fibrosis
result in fibrocaseous lesion, if healing not completed, extension of
lesion to surrounding tissue when reach the wall of bronchi, caseated
material coughed up leaving a cavity in the lung, the cavity have fibro-
caseous wall and by secondary organism inhaled in the cavity lead to
severe hemorrhage in cavity. Spread of active apical lesion may occur
by blood stream to give rise miliary T.B or by bronchial passages to
other parts of lung. When tuberculous cavity communicate with a
bronchus the highly infected sputum or caseous materials may
aspirated to another portions of lung.
Pulmonary tuberculosis: (granulomatous pneumonia):

9. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
The lung involvement with bilharzia is common accompanied the urinary
bilharzial cases and resulted into:
1. Vascular lesion (endarteritis obliterans and fibrinoid degeneration).
2. Parenchymal changes, alveolar wall thickening, diffuse granuloma,
allergy reaction is important with these infection.
Pulmonary hypertension:
1. Secondary to a known disease CVC, obstructive lung diseases,
pulmonary fibrosis, emphysema.
2. Primary-rare condition without preexisting or known case.
Pulmonary bilharziasis:

10. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Obstruction of bronchial lumen by:
1. Aspirated foreign material
2. Neoplasms
3. Pressure from outside
4. Inflammation or its sequelae
5. Asthma
Complete obstruction lead to collapse atelactasis of the lung tissue
supplied by obstructive bronchus, but incomplete obstruction lead to
emphysema.
Obstruction:

11. Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Occur by following causes:
1. Failure of expansion in newborn (congenital)
2. Compression of lung tissue
3. Bronchial obstruction.
Atelectasis accompanied by capillary dilation and congestion with intra-alveolar
hemorrhage and bronchiolar obstruction by compression, in stillborn children the lung
may completely atelectasis and airless. Compression atelectasis result from pressure
against lung tissue by exudates, air, pleurisy, tumors atelectasis lung is dark red, firm
and depressed below surrounding tissue, microscopically alveolar wall pressed together,
forming parallel bands, separated by narrow alveolar spaces.
Atelectasis:

12. PRESENTATION
ENDS
Copyrights © 2017 l Aliraqia University l Dentistry l Pathology l Prof.Dr. Khalil Hassan Zenad Aljeboori.
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