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Coin lesion -- considered malignant until proved otherwise

Coin lesion -- considered malignant until proved otherwise. Hamartoma - benign cartilaginous lesion. Cannon balls metastatic lesions. Metastases- irregularly sized and shaped lesions -- compare to previous CXR. Squamous cell carcinoma - large, irregular nuclei with keratin

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Coin lesion -- considered malignant until proved otherwise

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  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

  9. Small cell carcinoma

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

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

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

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

  14. Pneumothorax

  15. Laryngeal cancer

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

  17. Mesothelioma -- uniform cells invading pleura

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

  19. Pneumocystis carinii biopsy -- fluffy alveolar infiltrates

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

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

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

  23. Bacterial pneumonia -- PMNs in alveoli

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

  25. Legionaire’s disease

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

  27. Interstitial pneumonia -- lungs look fluffy

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

  29. Interstitial pneumonia -- thickened septa

  30. Fluorescent stain for Tb

  31. Acid fast stain for Tuberculosis

  32. Caseating granuloma -- immune competent pt

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

  34. Tuberculosis -- reactivation in upper lobes

  35. Miliary Tb -- disseminated

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