Enfermedad pulmonar obstructiva crónica
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This document discusses different types of chronic obstructive pulmonary disease (COPD) including emphysema and chronic bronchitis. It describes the pathology of emphysema, including different types like centriacinar, panacinar, and paraseptal emphysema. Chronic bronchitis is defined as a persistent cough with sputum production for at least three months out of the year for two or more years. The document also discusses asthma as a chronic inflammatory airway disease characterized by wheezing, shortness of breath, and airway obstruction that is at least partially reversible.
Enfermedad pulmonar obstructiva crónica
- 3. Enfermedad pulmonar obstructiva crónica Dr. Reynaldo Falcón Escobedo Profesor Titular Anatomía Patológica Facultad de Medicina UASLP
- 4. Enfermedad obstructiva vs. restrictiva Enfermedad obstructiva (enf. de las vías respiratorias) Aumento de la resistencia al flujo del aire Obstrucción parcial o completa de la vía respiratoria Desde tráquea hasta bronquíolos respiratorios y terminales Enfermedad restrictiva Expansión reducida del parénquima pulmonar Disminución de la capacidad pulmonar total Trastornos de la pared torácica Enfermedades intersticiales e infiltrativas agudas o crónicas.
- 6. Enfisema Dilatación permanente de los espacios aéreos distales al bronquíolo terminal Destrucción de septos ineralveolares
- 7. Tipos de enfisema Centroacinar Afección de partes centrales o proximales del lobulillo formadas por los bronquíolos respiratorios Alvéolos distales conservados Panacinar Acinos uniformemente agrandados, desde el bronquiolo respiratorio hasta el alvéolo. No afecta a todo el pulmón. Asociado a deficiencia de a1- antitripsina. Frecuentemente en zonas inferiores del pulmón Paraseptal Porción proximal normal, afección de la porción distal. Suele ser periférico, subpleural. A lo largo de los septos conectivos lobulillares y en los márgenes de los lobulillos. Aparece junto a zonas de fibrosis, cicatrización o atelectasia Mitad superior. Diámetro de 0.5 a >2 cm. Prob. asoc. A neumotórax espontáneo Irregular Probablemente la forma más común de enfisema. Se asocia casi invariablemente a cicatrrización
- 16. Bronquitis crónica Tos persistente productiva 3 meses al año 2 años consecutivos Sin ninguna otra causa aparente
- 19. Asma Trastorno inflamatorio crónico de vías aéreas Con episodios de recurrentes de sibilancias, disnea, tensión torácica y tos (por la noche y primeras h. del día) Asociados a broncoconstricción difusa variable Limitación al flujo del aire Reversible total o parcialmente espontáneamente o con tratamiento.
- 24. Figure 15-12 Bronchiectasis in a patient with cystic fibrosis, who underwent lung transplantation. Cut surface of lung shows markedly distended peripheral bronchi filled with mucopurulent secretions. Downloaded from: StudentConsult (on 9 November 2010 06:35 PM) © 2005 Elsevier
- 25. Figure 15-13 Schematic representation of current understanding of the pathogenesis of idiopathic pulmonary fibrosis. Downloaded from: StudentConsult (on 9 November 2010 06:35 PM) © 2005 Elsevier
- 26. Figure 15-15 Usual interstitial pneumonia. Fibroblastic focus with fibers running parallel to surface and bluish myxoid extracellular matrix. Honeycombing is present on the left. Downloaded from: StudentConsult (on 9 November 2010 06:35 PM) © 2005 Elsevier
- 27. Figure 15-14 Usual interstitial pneumonia. The fibrosis is more pronounced in the subpleural region. (Courtesy of Dr. Nicole Cipriani, Department of Pathology, University of Chicago, Chicago, IL.) Downloaded from: StudentConsult (on 9 November 2010 06:36 PM) © 2005 Elsevier
- 28. Figure 15-16 Cryptogenic organizing pneumonia. Some alveolar spaces are filled with balls of fibroblasts (Masson bodies), while the alveolar walls are relatively normal. A, Low power; B, high power. Downloaded from: StudentConsult (on 9 November 2010 06:36 PM) © 2005 Elsevier
- 29. Figure 15-17 Progressive massive fibrosis superimposed on coal workers' pneumoconiosis. The large, blackened scars are located principally in the upper lobe. Note the extensions of scars into surrounding parenchyma and retraction of adjacent pleura. (Courtesy of Drs. Werner Laquer and Jerome Kleinerman, the National Institute of Occupational Safety and Health, Morgantown, WV.) Downloaded from: StudentConsult (on 9 November 2010 06:36 PM) © 2005 Elsevier
- 30. HISTOLOGIC PATTERNS CLINICAL-RADIOLOGIC- PATHOLOGIC DIAGNOSES Usual Interstitial Pneumonia Idiopathic Pulmonary Fibrosis/ Cryptogenic Fibrosing Alveolitis Nonspecific Interstitial Pneumonia Nonspecific Interstitial Pneumonia (Provisional)‡ Organizing Pneumonia Cryptogenic Organizing Pneumonia † Diffuse Alveolar Damage Acute Interstitial Pneumonia Respiratory Bronchiolitis Respiratory Bronchiolitis Interstitial Lung Disease Desquamative Interstitial Pneumonia Desquamative Interstitial Pneumonia Lymphocytic Interstitial Pneumonia Lymphocytic Interstitial Pneumonia
- 31. HISTOLOGIC PATTERNS CLINICAL-RADIOLOGIC-PATHOLOGIC DIAGNOSES Usual Interstitial Pneumonia Idiopathic Pulmonary Fibrosis/ Cryptogenic Fibrosing Alveolitis Nonspecific Interstitial Pneumonia Nonspecific Interstitial Pneumonia (Provisional)‡ Organizing Pneumonia Cryptogenic Organizing Pneumonia † Diffuse Alveolar Damage Acute Interstitial Pneumonia Respiratory Bronchiolitis Respiratory Bronchiolitis Interstitial Lung Disease Desquamative Interstitial Pneumonia Desquamative Interstitial Pneumonia Lymphocytic Interstitial Pneumonia Lymphocytic Interstitial Pneumonia * Unclassifiable interstitial pneumonia = Some cases are unclassifiable for a variety of reasons (see text) † COP is the preferred term, but it is synonymous with Idiopathic Bronchiolitis Obliterans Organizing Pneumonia ‡ This group represents a heterogeneous group with poorly characterized clinical and radiologic features that needs further study. †† Modified From the ATS/ERS Classification of Idiopathic Interstitial Pneumonias1