Respiratory Intro

cytology respiratory

what is the function of respiratory system?

clean and warm inspired air
gas exchange
immune protection
voice production
olfaction

what are the respiratory systems 2 main function

ventilation
gas exchange

where are gasses exchanged?

alveoli

how many lobes does the L lung have, R lung?

Left 2
Right 3

The lungs are covered by a visceral....?

pleura

How are the two types of specimens taken?

Exfoliative - sputum, BB, BW, and BL's
Aspirate - FNA, bronchoscope ultrasound

What epithelium lines the oral cavity, pharynx, and more common in sputum?

Stratified squamous epithelium

What epithelium makes up the bronchus?

pseudostratified ciliated columnar epithelium

What ratio is seen between Ciliated bronchioles:Goblet cells

5:1 ratio

what is the purpose of ciliated epithelium?

To clear debris from the airways with mucus to trap dust and other things

Cilia propels mucus away from

the alveoli

What is goblet cells most characteristic feature

abundant mucin

What does an increase amount of goblet cells indicate?

asthma
allergies
hyperplasia
chronic bronchitis
bronchiectasis
smoker

If you see an abundant amount of goblet cells without ciliated cells....what does that suggest?

Mucinous adenocarcinoma

Clara cells become more numerous

distally

Clara cells produce surfactant to do what:

detoxes toxins by repair to clear airways

Kulchitsky cells can give rise to what carcinoma

SCC

What lines the alveoli?

type 1 and 2 pneumocytes

what do type 1 pneumocytes do?

gas exchange and covers the surface of the alveoli
they are flat and rarely seen

what are type 2 pneumocytes

secrete surfactant

where do alveolar macrophages originate from?

bone marrow

Present type 3 macrophages in a sputum sample indicates

the deep lung has been sampled

Alveolar macrophages are seen more in smokers. True or False

True

Alveolar macrophages should be abundant in BAL. True or False

True

Siderophages

blood laden

what do siderphages indicate?

old bleeding which can occur in benign/malignant conditions

what do lipophages indicate?

pneumonia
aspiration pneumonia
fat embolism
acute pancreatitis
tissue destruction
cancers

When are you likely to see Curschmann spirals?

Asthma
chronic bronchitis
cigarette smoking
lung cancers

What is asbestos coated with?

iron salts
glycoproteins

Is corpora amylacea calcified?

No, they are also bifringent

Sputum is more reliable in detecting which carcinoma type

SCC - squamous cell carcinoma

What will you see during BAL?

macrophages
ciliated bronchioles
pneumocytes
goblet cells

What specimen collection is best for detecting adenocarcinomas?

BAL

BAL is useful in detecting which type of infection?

Opportunistic organisms/infections

What collection method is reserve cell hyperplasia most commonly observed?

Bronchial brushings

Cytologically describe reserve cell hyplerplasia

Cells are uniform and tightly cohesive in size
hyperchromatic nuclei
high nc ratios
clean background

Reserve cell hyperplasia DD is small cell carcinoma. What are some differences between the two?

SCC - variable sizes, molding, crush artifact, salt and pepper chromatin
RCH - uniform size, no molding, even chromatin

What is the most common cause of squamous metaplastic cells to be in the lung?

It is the columnar cells response to injury - commonly caused by smoking

What is the follow up for squamous metaplasia?

Sputum samples

Parakeratosis in the lung, from severe irritation

can mimic SCC
can occur with squamous dysplasia or carcinoma

what is bronchial hyperplasia associated with

chronic disease of the lung

Bronchial hyperplasia cytologically

creola bodies
papillary
3d compact group
finely granular chromatin
regular uniform nucleoli

When will you see charcot Leyden crystals

asthma
allergies
healing stage of Loffler's Syndrome