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

2. Pigments
Definition:
colored substances
in the organism
or environment

3. Pigments endogenous Classification: autogenous exogenous
hemoproteins derived
autogenous
exogenous

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

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

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

7. 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

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

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

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

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

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

13. 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)

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

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

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

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

18. 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.

19. 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?

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

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