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My approach to interstitial lung disease using clinical, radiological and histopathological patterns.

Leslie KO - J. Clin. Pathol. (2009)

Bottom Line: The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting.The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis.A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

View Article: PubMed Central - PubMed

Affiliation: Division of Anatomic Pathology, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA. leslie.kevin@mayo.edu

ABSTRACT
The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting. The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis. A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

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Related in: MedlinePlus

Plexiform lesion of pulmonary hypertension. This classical plexiform lesion is composed of a pulmonary artery profile (upper right of centre) with an adjacent glomeruloid structure (lower left of centre). An early dilatation lesion is also present here (thin-walled, dilated vessels at the edges of the complex). H&E stain, 40× original magnification.
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CPT-62-05-0387-f30: Plexiform lesion of pulmonary hypertension. This classical plexiform lesion is composed of a pulmonary artery profile (upper right of centre) with an adjacent glomeruloid structure (lower left of centre). An early dilatation lesion is also present here (thin-walled, dilated vessels at the edges of the complex). H&E stain, 40× original magnification.

Mentions: Diseases affecting the pulmonary arteries, veins and lymphatics can produce subtle changes in the surgical lung biopsy specimen. A careful and systematic evaluation of these structures is always justified when pattern 6 is encountered. When chronic disease is present in the bronchioles (such as may occur with peribronchiolar metaplasia and constrictive bronchiolitis), the adjacent arteries may become irregularly thickened and tortuous without apparent physiological consequences of pulmonary hypertension. Before considering a histopathological diagnosis of pulmonary hypertension, plexiform lesions (fig 30) or many hypereosinophilic arterioles with concentric luminal compromise (to the point of near-obliteration) should be evident.


My approach to interstitial lung disease using clinical, radiological and histopathological patterns.

Leslie KO - J. Clin. Pathol. (2009)

Plexiform lesion of pulmonary hypertension. This classical plexiform lesion is composed of a pulmonary artery profile (upper right of centre) with an adjacent glomeruloid structure (lower left of centre). An early dilatation lesion is also present here (thin-walled, dilated vessels at the edges of the complex). H&E stain, 40× original magnification.
© Copyright Policy - openaccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2668105&req=5

CPT-62-05-0387-f30: Plexiform lesion of pulmonary hypertension. This classical plexiform lesion is composed of a pulmonary artery profile (upper right of centre) with an adjacent glomeruloid structure (lower left of centre). An early dilatation lesion is also present here (thin-walled, dilated vessels at the edges of the complex). H&E stain, 40× original magnification.
Mentions: Diseases affecting the pulmonary arteries, veins and lymphatics can produce subtle changes in the surgical lung biopsy specimen. A careful and systematic evaluation of these structures is always justified when pattern 6 is encountered. When chronic disease is present in the bronchioles (such as may occur with peribronchiolar metaplasia and constrictive bronchiolitis), the adjacent arteries may become irregularly thickened and tortuous without apparent physiological consequences of pulmonary hypertension. Before considering a histopathological diagnosis of pulmonary hypertension, plexiform lesions (fig 30) or many hypereosinophilic arterioles with concentric luminal compromise (to the point of near-obliteration) should be evident.

Bottom Line: The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting.The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis.A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

View Article: PubMed Central - PubMed

Affiliation: Division of Anatomic Pathology, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA. leslie.kevin@mayo.edu

ABSTRACT
The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting. The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis. A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

Show MeSH
Related in: MedlinePlus