CHRONIC NONSPECIFIC DISEASES OF LUNGS LUNG CANCER

CHRONIC NONSPECIFIC DISEASES OF LUNGS (CNSLD) — chronic bronchitis; — lung emphysema; — bronchial asthma; — bronchoectasis; — interstitial diseases of lungs; — pneumofibrosis (pneumocirrhosis).

MECHANISMS OF CNSLD DEVELOPMENT Bronchitogenic – results from disturbances of drainage and conductive functions of bronchi and provides development of chronic obstructive diseases of lungs (chronic bronchitis, bronchoectasis, bronchial asthma, lung emphysema (mainly chronic diffuse obstructive)). Pneumoniogenic with acute pneumonia and its complications. It provides development of chronic nonobstructive diseases of lungs (chronic abscess, chronic pneumonia). Pneumonitogenic - provides development of chronic interstitial diseases of lungs (different forms of fibrous alveolitis or pneumonitis). Finally, all mechanisms cause the development of pneumosclerosis, secondary lung hypertension, hypertrophy of right heart ventricle and cardiovascular failure.

Normal lungs

CHRONIC BRONCHITIS Clinical symptoms (cough and sputum expectoration) occur on 3 months of year during 2 years. Chronic bronchitis — chronic inflammation of bronchi, resulting from prolonged acute bronchitis (ex., after grippe) or prolonged action on the bronchus mucous coat of bacteria (ex., Haemophilus influenzae, Streptococcus pneumoniae) or viruses (ex., RS-virus, adenovirus), physical and chemical factors (smoking, atmospheric pollutions, cold and other).

CHRONIC BRONCHITIS CHRONIC CATARRHAL BRONCHITIS CHRONIC POLYPOUS BRONCHITIS CHRONIC DEFORMATIVE BRONCHITIS

Chronic polypous bronchitis

Chronic bronchitis with mesh pneumosclerosis

BRONCHOECTASIS are characterized by stabile dilatation of bronchus or bronchioles. Classification: According to appearance: congenital acquired According to morphology: cylindrical saccular fusiform varicose

BRONCHOECTASIS Bronchoectatic disease is complex of pulmonary and extrapulmonary changes in bronchoectasis availability. Complications of bronchoectasis: — pneumonia; — empyema of pleura; — septicaemia; — meningitis; — metastatic abscesses (ex., in the brain); — secondary systemic amyloidosis.

PULMONARY EMPHYSEMA is defined as combination of permanent dilatation of air spaces distal to the terminal bronchioles and the destruction of the walls of dilated air spaces. Thus, emphysema is defined morphologically, while chronic bronchitis is defined clinically. Since the two conditions coexist frequently and show considerable overlap in their clinical features, it is usual to label patients as 'predominant emphysema' and 'predominant bronchitis'. Classification: — chronic diffuse obstructive; — chronic focal ; — compensatory; — primary (idiopathic) pan-acinar; — senile (aging lung); — interstitial.

EMPHYSEMATOUS CHEST

Normal EMPHYSEMA

emphysema

PULMONARY EMPHYSEMA

BRONCHIAL ASTHMA Asthma is a disease of airways that is characterized by increased responsiveness of the tracheo-bronchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the air passages which may be relieved spontaneously or by therapy. Asthma is an episodic disease manifested clinically by paroxysms of dyspnoea, cough and wheezing. However, a severe and unremitting form of the disease termed status asthmaticus may prove fatal. CLASSIFICATION: — atopic; — non-atopic; — induced by aspirin; — professional; — allergic bronchopulmonary aspergillosis.

BRONCHIAL ASTHMA pathomorphological changes: — narrowing of bronchial lumen, which leads the atelectasis or, convertly, increase of air in alveoli; — obstruction of bronchi with sputum; — inflamation of bronchi ; — appearance of Kurshman`s spirals (desquamated epithelium and sputum) ; — appearance of Sharco- Leiden`s (cristales in aggregates of oesinophyles; — hypertrophy of mucous glands ; — hypertrophy of smooth muscular tissue; — thickness of basal membrane.

BRONCHIAL ASTHMA

INTERSTITIAL DISEASES OF THE LUNGS are subdivided into acute and chronic forms. 2 types of changes develop in lungs: 1) primary lesion of alveoli with father fibrosis, 2) primary lesion of interstitium with father fibrosis.

ACUTE INTERSTITIAL DISEASES OF THE LUNGS — respiratory distress syndrome of adult persons; — toxic and drug alveolitis; — radiation pneumonitis; — diffuse intrapulmonary hemorrhages (Goodpasture's Syndrome).

CHRONIC INTERSTITIAL DISEASES OF THE LUNGS — idiopathic pulmonary fibrosis; — pneumoconiosis; — sarcoidosis; — hystiocytosis Х; — alveolar lipoproteinosis.

PNEUMOCONIOSIS Pneumoconiosis is the term used for lung diseases caused by inhalation of dust, mostly at work. These diseases are, therefore, also called 'dust diseases' or 'occupational lung diseases'. The type of lung disease varies according to the nature of inhaled dust. Some dusts are inert and cause no reaction and no damage at all, while others cause immunologic damage and predispose to tuberculosis or to neoplasia. The factors which determine the extent of damage caused by inhaled dusts are: 1. size and shape of the particles; 2. their solubility and physic-chemical composition; 3. the amount of dust retained in the lungs; 4. the additional effect of other irritants such as tobacco smoke; 5. host factors such as efficiency of clearance mechanism and immune status of the host.

PNEUMOCONIOSIS

1. Idiopathic pulmonary fibrosis 2. “Honeycomb» lung

Silicosis of the lungs (general view)

Silicosis of the lungs

Silicotic nodule

Anthracosis Cellular "light Fibrosing alveolitis

asbestosis Malignant mesothelioma of the pleura on the background of asbestosis The defeat of the pleura in asbestosis

Pneumosclerosis

“Drumsticks “," watches glass "

Chronic pulmonary heart

Central lung cancer Peripheral lung cancer

Lung cancer

)Squamous cell carcinoma 2)Bronchoalveolar carcinoma 3)Smallcellular carcinoma

Hamartoma of lung

Мicropreparations

Bronchoectasis and pneumosclerosis

Pneumosclerosis

EMPHYSEMA

Anthracosis