Exogenous Pigments General Pathology Basic Principles of Cellular and Organ Pathology Exogenous Pigments Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague

Pigments Definition: colored substances in the organism or environment

Pigments endogenous Classification: autogenous exogenous hemoproteins derived autogenous exogenous

Exogenous Pigments traumatic lesions gastrointestinal tract - colored substances entering the organism via traumatic lesions gastrointestinal tract respiratory tract

Exogenous Pigmentation traumatic origin – tatuatio traumatica, arteficialis gastrointestinal tract – intoxicatio Pb, Ag, Au, Fe (!)

Exogenous Pigmentation traumatic origin – tatuatio traumatica, arteficialis mechanic instilation of inert dyes (china ink) into the deep dermis

Tatuatio arteficialis - therapy LASER = Light Amplification by Stimulated Emission of Radiation low performance laser – biostimulation high performance laser – destruction of pigmentation shifts – postinflammatory, melasma, tatoo SURGERY / CRYOSURGERY COMBINATION COVER UP

Tatoo inert – persistent macrophage degraded macrophage transported secondary lymph node pigmentation

Exogenous Pigmentation gastrointestinal tract – intoxicatio Pb, Ag, Au, Fe (!)

Exogenous Pigmentation through Airways PNEUMOCONIOSES Def.: conditions or diseases elicited with dust particles inhalation (<5)

Pneumoconioses – coniosis simplex (anthracosis, siderosis) – coniofibrosis (silicosis, asbestosis, coal workers disease, siderosis) – coniotoxicosis  conioalergosis (byssinosis, berylliosis) organic dusts

Anthracosis Def.: pneumoconiosis caused by inert coal-like dust (without quartz admixture) no symptoms = coniosis simplex 100% population prevalence

Silicosis Def.: pneumoconiosis caused by quartz dust with pronounced fibrosis response CONIOFIBROSIS long lasting exposition (20–40 years) progression even after exposure elimination part of miners disease affinity to other lung diseases (tbc)

Silicosis Stages: diffuse reticular fibrosis (often clinically silent) silicotic nodules (+ perifocal emphysema) massive fibrosis

Silicosis Pathogenesis: toxic activity of quartz dust to macrophages production of PDGF1, IGF-1, fibronectin chemotaxins, IL-8 enzyme activation, lung injury, inflammation, FIBROSIS

Silicosis cardiorespiratory insuffitiency Complications: pulmonary fibrosis pulmonary hypertension cor pulmonale Cause of death cardiorespiratory insuffitiency

Coal Workers Pneumoconiosis - CWP Coal macules- dust laden macrophages Coal nodules – mild collagen admixture Advanced Combined silicosis & anthracosis complicated often with tbc

Asbestosis Def.: pneumoconiosis caused by Asbestos fibrils with pronounced fibrotising response CONIOFIBROSIS Asbestos fibrillar mineral with various forms and fibrogenic capacity chrysotile (90%), amosite, croccydolite etc.

Asbestosis Pathogenesis: toxic influence due to fibrils size and concentration fibrosis with feruginous bodies hyalin pleural plaques risk of mesotelioma and lung carcinoma pleural effusions („mesot. in situ“ – Bedrosjan 2004) other neoplasiae?

Pneumoconioses – coniosis simplex (anthracosis, siderosis) – coniofibrosis (silicosis, asbestosis, coal workers disease, siderosis) --------------------- – coniotoxicosis  conioalergosis (byssinosis, berylliosis,….) cotton

Coniotoxicosis  Conioalergosis Berylliosis acute - toxic pneumonitis chronic – non caseating granulomas Byssinosis – cotton dust Farmer´s lung – moldy hay, actinomycetes, Bird fanciers disease - bird dust