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Mawad
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Lung tissue color on necropsy depends upon the relative amounts of... (4)
lung tissue (white), other tissues/cells (white), blood (red), air (translucent)
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Darker than normal color of lung tissue can means... (2)
relatively more blood (congestion) or less air (atelectasis)
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Ligher than normal color of lung tissue can mean... (4)
relatively more air, clear fluid (edema), less blood (anemia), more cells (exudate, hyperplasia, neoplasia)
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What is the most important aspect of examining lungs on necropsy?
distribution of lesions
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What does the anterior-ventral (cranio-ventral) pattern suggest? (5 important points)
airborne pathogenesis--> bronchopneumonia; usually consolidation (firm consistency), well-demarcated boundary; dark early (hyperemia with early inflammation), light late (neutrophils and other WBCs arrive to fight infection)
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What type of pattern indicates bronchopneumonia?
anterior-ventral pattern
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What does the hilar pattern suggest? (6 important points)
vascular pathogenesis--> interstitial pneumonia; semicircular around hilus, may be firmer/denser than normal; dark due to congestion; poorly demarcated boundary
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What type of patterns suggest vascular pathogenesis?
hilar pattern, diffuse pattern, milliary pattern, sometimes focal pattern
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What type of pattern suggests airborne transmission?
anterior-ventral pattern, sometimes focal pattern
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What type of pattern indicates interstitial pneumonia?
hilar pattern
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What etiologies are usually associated with a hilar pattern? (2)
viral or pulmonary edema
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What does diffuse pattern suggest? (5 important points)
vascular pathogenesis --> extension of hilar pattern w/ minimal or no normal; congestion (dark), edema (wet), dense
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What does a milliary pattern suggest? (3 important points)
embolic shower from bacterial infection or neoplastic disease; dark red (hemorrhage, endothelial damage, DIC, coagulopathy) OR light (necrosis, inflammation)
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What are the major etiologies of milliary pattern? (2 big, 2 less common)
bacteremia (emboli), neoplasia (metastatic tumors) [much less commonly- coagulopathy, multifocal necrosis]
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What does a dark focal pattern indicate? (5)
hemorrhage, infarct, atelectasis, pigment, neoplasm
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What does a light focal pattern indicate? (3)
abscess, granuloma, neoplasm
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What type of pathogenesis does focal pattern suggest?
airborne or vascular [if vascular, look at other organs to see if the infection had spread from somewhere else in the body]
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What are the 2 types of multifocal pattern and what does each suggest?
- uniform multifocal- lesions occurred at the same time- hemorrhage, necrosis, emboli
- nonuniform multifocal- lesions are different ages- abscesses or neoplasms with different growth rates
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How do primary metastatic lung tumors usually appear?
single large focus (primary tumor)--> grows and eventually sends out mets--> one large primary tumor surrounded by smaller foci (mets)
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What causes a smaller lung size?
atelectasis (compressive atelectasis- fluid or air in pleural cavity compressing lungs)
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What causes larger than normal lung size? (2)
emphysema, interstitial pneumonia
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How can you tell lungs were smaller than normal size on necropsy? (2)
dense, wrinkled pleura
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How can you tell lungs were larger than normal on necropsy? (4)
light color, light weight, don't collapse, rib impressions
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What can cause heavier than normal lungs? (4)
congestion/hemorrhage, hyperplasia/neoplasia, inflammatory exudate, edema
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What should the consistency of lung be?
crepitance (air filled)
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What does structural integrity versus no structural integrity indicate?
- structural integrity= not spreadable= viable organized tissue= neoplasia
- no structural integrity= loose cells, debris= necrosis, exudate
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What does a raised contour indicate? (4)
increased number of cells, tissue, fluid, air- neoplasia, exudate, bronchiectasis, hemorrhage
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What does depressed contour indicate? (2)
necrosis, atelectasis
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What types of lesions have well-demarcated margins? (3)
abscesses, granulomas, neoplasms
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What types of lesions usually have poorly demarcated margins? (2)
poorly contained inflammation, fluids
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What contour do these lesions have?
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