Lecture 21 diseases of respiratory system

Prof.Dr.
Khalil Hassan Zenad
Aljeboori
Copyrights©2017lAliraqiaUniversitylDentistrylPathologylProf.Dr.KhalilHassanZenadAljeboori.
Lecture 21
DISEASES OF RESPIRATORY
SYSTEM

Abnormal increase of air contents of tissue, there is
distended alveoli, thin alveolar wall and loss of
elasticity, rupture of alveolar wall .Acute pulmonary
emphysema occur in death from esphyxia, anaphylactic
shock, poisonous gases.
Emphysema:

occur in large lung is associated with increase in the residual air content of the lungs, the
chest is to be barrel-shaped with wide costal angle and low position of diaphragm. The
decrease pulmonary mobility and elasticity and obliteration of alveolar capillaries cause
stagnation of pulmonary circulation and throw more work on right heart lead to
hypertrophy, failure of heart and passive congestion. Partial obstruction is the cause of
this type of emphysema.
Senile emphysema:
occur in small lung also associated with barrel-shaped chest and hyper resonant lung. The
primary change appear to be stiffening and straightening of thoracic spine which
associated with degenerative changes in intervertebral disc. The lung follow the change
in shape of chest. They collapse on opening the chest since their elasticity is not greatly
impaired, lung are not actually enlarged.
Obstructive emphysema:

In which air is present in the interstitial spaces of lung rather than in alveoli
air escaped through ruptured alveolar bases into sheath of pulmonary
vessels, precipitated, by pressure gradiant of air in alveoli to perivascular
sheath in cases where alveoli are over expanded or blood vessels not filled
to normal extent.
Predisposing conditions:
1. General over inflation of lung tissue.
2. Atelactasis of an area of lung with over inflation of adjacent areas.
3. Decreased blood supply of pulmonary vessels with hyperinflation or
increased intra alveolar pressure.
Pulmonary interstitial emphysema:

Pulmonary changes due to inhalation of dust depend on type of dust inhaled, length of
time exposure and associated infection.
1. Anthracosis- inhalation of carbon pigment, is unimportant clinically.
2. Silicosis: inhalation of silica, it is irritant cause nodular area of fibrosis, some time
associated with T.B or accelerate infection, silicosis predispose to right heart failure.
3. Asbestosis: inhalation of asbestosis fibers, result in diffuse fibrosis in the lung a
characteristic asbestose bodies are elongated club shape fibers coated with iron
pigment are found in lung tissue or in sputum also asbestosis predispose to right heart
failure.
4. Silicosiderosis: occur among hematite miners and the lung appear bright bricked color.
Pneumoconiosis:

5. Berylliosis: inhalation of beryllium containing dust employed in manufacture of
fluorescent lighting tubes, radio-television industries associated with focal fibrosis,
emphysema, ephithelioid granuloma like sarcoid.
6. Byssinosis- a disease of cotton mill workers.
7. Bagassosis: workers producing insulating material from dried sugar cane refuse.
Both type 6th and 7th lead to bronchitis, emphysema, asthma, and allergy.
8. Farmer lungs -due to breathing dust during the handling of mouldy hay or corn.
9. Alveolar pronteinosis -rare disease unknow etiology, the lung reveal to deposition
pink staining material in alveoli contain protein and lipid without inflammatory
reaction.
Other less important types are:

1. Progressive interstitial pulmonary fibrosis:
Lung fibrosis of unknown etiology characterized by diffuse and interstitial fibroses, it is
rare disease include:
a) Hamman-rich syndrome: acute progressive interstitial fibrosis terminate in death.
b) Diffuse interstitial fibrosis-fibrosing alveolitis, similar to hamman-rich syndrome but
slower progression.
2.Honey comb lung:
Cystic or honey comb lung appearance the cystic spaces derived by distension of
alveolar ducts which follow alveolar spaces obliteration due to:
a) Non specific broncho pneumonia or collapse.
b) Specific infection T.B, sarcoidosis eosinophil granuloma, giant cell pneumonia…etc.
Other types of pulmonary fibrosis:

Benign tumors:
1. Bronchial adenoma
2. Chondroma
3. Leiomyoma of bronchial muscles.
Malignant tumors:
1. Carcinoma, bronchogenic carcinoma either squamous or epidermoid type.
2. Oat cell carcinoma or basal cell type.
3. Small cell or undifferentiated type.
4. Bronchiolar or alveolar carcinoma.
5. Adenomucoid or gelatinous carcinoma of bronchial glands.
6. Metastatic carcinoma.
7. Metastatic sarcoma.
Tumors of the lungs:

• Mediastinal lymph node tumor:
Hodgkins lymphoma
Non Hodgkins lymphoma
Cystic lymphangioma
 Ganglioneuroma and neurofibroma of nerve roots adjacent to
vertebral column in intrathoracic region of mediastinum.
 Benign teratoma of anterior mediastinum are not uncommon.

Pleurisy, pleuritis:
Inflammation of pleura-usually spread from lung, some cases from abdomen
and mediastinum or from blood the infection mainly by T.B pneumococci,
streptococcus.
Pleurisy is classified according the type of exudates:
1. Fibrinos (dry pleurisy)
2. Serofibrinous ( pleurisy with effusion).
3. Purulent (empyema). The fluid in pleurisy either fluid contain fibrin flakes
or fibrin inflammatory cells or may organized pleurisy with fibrous tissue
causing adhesion of visceral and parietal layer of pleura.
Diseases of pleura:

occur due to streptococci and pneumococci
infection of lung, organization and formation of
adhesion to localize pus in pleura.
Empyema:

Hydrothorax:
Accumulation of edema fluid or transudate in pleural cavity it occur in condition of
generalized edema, renal and cardiac disease rare condition such as tumor or
aneurysm, fluid yellow clear , low protein content similar to transudate.
Hemothrax:
Blood in pleural cavity, occur in the case of thoracic trauma, rupture from aneurysm.
Fluid are stained with blood , it’s occurance with T.B or tumors of lung or pleura.
Pneumothorax:
Air in pleura may occur in rupture of lung such as in T.B or emphysema , in certain
cases air in pleura is associated with serous or inflammatory exudates.
Pleural effusion:

1.Disease of bronchi:
a)Foreign body impaction.
b)Bronchitis.
c)Bronchial adenoma.
d)Bronchiectasis.
e)Bronchogenic carcinoma.
f)Erosion of bronchus or trachea by aortic aneurysm, esophageal
carcinoma, mediastinal tumors.
Hemoptysis:
Is expectoration of blood due to:

2. Diseases of lung:
a)Penetrating injury.
b)Chronic venous congestion.
c)Infarction.
d)Pneumonia.
e)Lung abscess.
f)Tuberculosis.
g)Actinomycosis.
h)Secondary tumors.
Hemoptysis:

3.Hemorrhagic blood disease:
a) Purpura.
b)Leukemia.
c) Hemophilia.
Hemoptysis:

Radiologic examination showed shadow circular outline has no specific
or distinguishing radiological features on chest so coin lesion describe
such conditions:
1. Granuloma, T.B, abscess aspergillosis,actinomycosis, blastomycosis,
cryptococcosis, histoplasmosis, moniliasis, coccidioidomycosis,
eosinophil granuloma, syphilitic gumma.
2. Parasite cyst, hydatid cyst.
3. Tumors, carcinoma, metastatic carcinoma, hamartoma, adenomas.
The most common is T.B, other lesion varied in geographical region to
other.
Coin lesions:

Lecture 21 diseases of respiratory system

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Lecture 21 diseases of respiratory system

Similar to Lecture 21 diseases of respiratory system (20)

More from Green-book

More from Green-book (20)

Recently uploaded

Recently uploaded (20)

Lecture 21 diseases of respiratory system