PA Lung

Faktor risiko lung cancer

Smoking, radon, outdoor pollution, airborne particle, airborne particle

Metode untuk sampling (4)

Biopsi saat bronchoscopy
Bronchoalveolar lavage
Trans-thoracal needle biopsy
Pleural effusion

Sebutkan semua lesi prekursor

Atypical adenomatous hyperplasia
Adenocarcinoma in situ
Squamous dysplasia and carcinoma in situ

Sebutkan lesi ganas

Adenocarcinoma, squamous carcinoma, lung neuroendocrine neoplasma, large cell carcinoma

Atypical adenomatous hyperplasia

Atypical adenomatous hyperplasia - club cells and pneumonia II

AIS Mucinous

AIS Non Mucinous

Severe Dysplasia

Squamous Metaplasia

Squamous carcinoma in situ

Lepidic + acinar adenocarcinoma

Micropapillary adenocarcinoma

Papillary adenocarcinoma

Acinar adenocarcinoma

Solid adenocarcinoma

Mucinous adenocarcinoma of the lung

Keratinizing SCC

Non keratinizing SCC

Typical carcinoid tumor (salt & pepper appearance)

Atypical carcinoid tumor

Small cell carcinoma

Small cell carcinoma (yang dilingkari itu organoid)

Large cell neuroendocrine carcinoma

Large cell neuroendocrine carcinoma

Apa kriteria diagnosis lung neuroendocrine neoplasm?

Ki-67 proliferation index

TTF1 exprestion

p40 expression (negatif semua)

Lung abses (dikelilingi jaringan granulasi dengan kapiler proliferatif dan infiltrat sel radang)

Abses

Terdiri dari debris nekrotik, sel radang (kanan), dikelilingi jaringan granulasi (kiri) yang terdiri dari fibroblast, sel radang, kapiler

Viral Pneumonia

cytomegalovirus inclusion body pneumonia

interstitial pneumonia dimana inflamasi menyebabkan scarring.

Sel radang neutrofil + area necrosis + perdarahan

Anthracosis (debris hitam juga dapat ditemukan dalam makrofag)

Hemorrhagic infarct of lung

Daerah nekrosis (infarct) yang perhubungan dengan perdarhaan alveolar (kanan). Area sebelah kiri masih tampak alveoli yang mengalami nekrosis koagulatif

Lung tuberculosis

Granuloma → nekrosis caseosa, sel epitheloid, datia langhans

Adenocarcinoma of the lung (lepidic)

Non Keratinizing Squamous cell carcinoma of the lung

Membentuk gambaran seperti nesting (sarang)

Semua neuroendocrine neoplasma

Neuroendocrine tumor

1. Typical carcinoid

2. Atypical carcinoid

Neuroendocrin carcinoma

1. Small cell carcinoma

2. Large cell neuroendocrine carcinoma

Diffuse alveolar damage - ada well formed hyaline membranes

Diffuse alveolar damage

GPA (granulomatosis with polyangiitis)/Wegener’s

• Geographic necrosis pattern

Wegener’s

Wegener’s

EGPA (esinophilic granulomatosis with poliangiitis)/Churg-strauss syndrome

• Necrotizing granulomatous inflammation + eosinophilia + necrotizing vasculitis (small-medium vessels)

Trias GPA/Wegeners

• Necrotizing vasculitis

• Aseptic necrosis (in upper respiratory tract and lungs)

• Focal glomerulitis

Emphysema (obstructive disease)

Usual interstitial pneumonia

• Patchwork fibrosis + honeycomb

Non-specific interstitial pneunomia

• Uniform fibrosis

Desquamative IP

• Alveolus dipenuhi makrofag

Lymphoid Interstitial pneumonia

• jaringan paru penuh sel limfosit

Anthracosis

• Pigmen hitam di paru

• Pada perokok berat atau tinggi polusi

• Fibrosis minimal

Asbestosis

• Menghirup absestos

• Asbestos bodies

Silicosis

• Menghirup silika/silicon dioxide

Asbestos body in asbestosis

Lobar pneumonia

Sarcoidosis

Tuberculosis

Large cyst (>2cm) in CCAM/CPAM

• Congenital cystic disease

• Intercommunicating cysts lined by adenomatoid epithelium

Small cyst (<2cm) in CCAM/CPAM

• Congenital cystic disease

• Intercommunicating cysts lined by adenomatoid epithelium