病理学英文课件：呼吸系统疾病

1、呼吸系统疾病,Diseases of Respiratory System,Anatomy and Histology The Upper Respiratory Tract the nose, pharynx and larynx Cricoid cartilage The Lower Respiratory Tract the trachea, bronchi and lungs,Trachea Bronchus Lobar bronchus Segmental bronchus Bronchiole Terminal bronchiole Respiratory bronchiole A

2、lveolar ductAlveolar sac Alveolus,Trachea chemotherapy responsive,Lung cancer,Small cell carcinoma: Macroscopic,Most are central type, 70% of cases present as perihilar mass. Extensive lymph node metastases are common. Typically peribronchial; endobronchial lesions are uncommon,Small cell carcinoma:

3、microscopic,Small cells grow in clusters “ oat cell” Round to fusifrom nuclei, and finely granular chromatin Nuclear molding Faint or absent nucleoli Scant cytoplasm The tumor cells are markedly fragile. Extensive necrosis Mitotic figures are frequently seen,CgA,EM: neurosecretory granules,Clinical

4、Course,Insidious, aggressive and poor outlook (10%) Cough, weight loss, chest pain, dyspnea, solitary tumor Can be associated with a number of paraneoplastic syndromes (1%-10%) Sputum: diagonostic tumor cells / bronchial brushings and biopsy / Fine-needle aspirate Mainly lymphatic metastasis Surgery

5、, radiation and chemotherapy Earlier examination, diagnosis and treatment,Lung cancer,Paraneoplastic syndromes,Hypercalcemia caused by secretion of a parathyroid hormone-related peptide Cushing syndrome (from increased production of adrenocorticotropic hormone) Sydrome of inappropriate secretion of

6、antidiuretic hormone. Neuromuscular syndromes, including a myasthenic syndrome, peripheral neuropathy, and polymyositis,Paraneoplastic syndromes,Clubbing of the fingers and hypertrophic pulmonary osteoarthropathy Hematologic manifestations, including migratory thrombophlebitis, nonbacterial endocard

7、itis, and disseminated intravascular coagulation,类癌综合征,因癌细胞分泌多种异位激素（如5-羟色 胺）引起，表现为支气管痉挛、阵发性心 动过速、水样腹泻和皮肤潮红等,Clinical Course,Insidious, aggressive and poor outlook (10%) Cough, weight loss, chest pain, dyspnea, solitary tumor Can be associated with a number of paraneoplastic syndromes (1%-10%) Sputum

8、: diagonostic tumor cells / bronchial brushings and biopsy / Fine-needle aspirate Mainly lymphatic metastasis Surgery, radiation and chemotherapy Earlier examination, diagnosis and treatment,Lung cancer,Lung cancers spread by four main routes,Local spread Lymphatic spread Transcoelomic spread Hemato

9、genous spread,Local spread,Superior vena caval syndrome Pericardial or pleural effusion Persistent segmental atelectasis or pneumonitis,上腔静脉综合征,肺癌癌肿侵犯纵隔，压迫上腔静脉引 起面颈部浮肿及颈、胸部静脉曲张,Local spread,Apical neoplasms may invade the brachial or cervical sympathetic plexus to cause severe pain in the distribution of the ulnar nerve or to produce Horner Syndrome (ipsilateral enophthalmos, ptosis, meiosis, and anhidrosis,H