1. Coin lesion -- considered malignant until proved otherwise

2. Hamartoma - benign cartilaginous lesion

3. Cannon balls metastatic lesions

4. Metastases- irregularly sized and shaped lesions -- compare to previous CXR

5. Squamous cell carcinoma - large, irregular nuclei with keratin more common men than women, most arise in bronchi, obstruction is presenting feature

6. Adenocarcinoma -- tall, columnar cells mucin (+) women, non-smokers <40 yoa, associated with scars, slow growing but metastasize early

7. Large cell carcinoma -- aggressive

8. Small cell carcinoma- basophilic cells with areas of necrosis, lymph-like cells (oat cells) derived from neuro-endocrine cells Associated with paraneoplastic syndromes

10. Small cell carcinoma

11. Endobronchial carcinoma This one is too high to be resected

12. A small endobronchial carcinoid (right). Histologically, there are well-defined nests of homogeneous cells with uniform nuclei (left).

13. Mesothelioma -- related to which type of asbestos? Amphibole (straight)

14. Pleural effusion must tap to determine if transudate or exudate

15. Pneumothorax

16. Laryngeal cancer

17. Squamous carcinoma -- hyperkeratosis, associated with alcohol and smoking Presentation: persistent hoarseness

18. Mesothelioma -- uniform cells invading pleura

19. Pneumocystis carinii hypoxemia, no infiltrate common in immunosuppressed pts

20. Pneumocystis carinii biopsy -- fluffy alveolar infiltrates

21. Lobar pneumonia - - classically what bt? Strep pneumo

22. Lobar pneumonia Stage 3 Gray hepatization -- PMNs ingesting and destroying RBCs

23. Acute bacterial pneumonia -- early red hepatization with neutrophils

24. Bacterial pneumonia -- PMNs in alveoli

25. Bronchopneumonia -- common organisms? Strep pneumo, H flu, Legionella, Pseudomonas

26. Legionaire’s disease

27. Bronchopneumonia -- some normal alveoli, congestion near bronchi

28. Interstitial pneumonia -- lungs look fluffy

29. Interstitual pneumonia -- somealveoli filled, few inflammatory cells

30. Interstitial pneumonia -- thickened septa

31. Fluorescent stain for Tb

32. Acid fast stain for Tuberculosis

33. Caseating granuloma -- immune competent pt

34. Ghon’s complex -- primary focus plus regional lymph node

35. Tuberculosis -- reactivation in upper lobes

36. Miliary Tb -- disseminated