Los Angeles Monthly Meeting of the Religious Society Of Friends

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Clinical and diagnostic management of toxoplasmosis in the immunocompromised patient. They are divided into low- and high-grade types, based on morphological and cytological features. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. The difficulty arises because melanomas have a propensity to progressively dedifferentiate with successive metastases. In women the highest risk was for engine operators, tobacco workers and other construction workers. In fully developed lesions, damage to the bronchial wall becomes irreversible, with replacement of most respiratory epithelium by inflamed granulation tissue. Acute respiratory distress syndrome: underrecognition by clinicians and diagnostic accuracy of three clinical definitions. A variety of bacterial infections including Pseudomonas, Mycoplasma and chlamydial organisms, as well as viruses and fungi, can produce a similar histological pattern and should be excluded by culture and/or serological testing. While comprehensive descriptions and discussions of these topics are found elsewhere in this text, focused comments are offered. Median survival for those with extensive-stage disease is 8:13 months with 5% surviving 2 years. Signs and symptoms are nonspecific and include low-grade fever, cough, drop in arterial oxygenation or expiratory flow rates, or new onset and/or increase in pulmonary infiltrates or pleural effusions. Typical and atypical pulmonary carcinoids: outcome in patients presenting with regional lymph node involvement. If not for the obvious keratin pearl, one would be unlikely to consider this lesion a squamous cell carcinoma. Radiographic regression is also reported, probably secondary to decreased estrogen and/ or progesterone levels. A delicate lattice-like alveolar septal fibrosis involves the majority of two lobules. Sometimes, small concretions are Clinicopathological correlation this tumor is treated with conservative surgical resection aimed at sparing lung parenchyma. By virtue of invasion or involvement of mediastinal lymph nodes, these tumors compromise mediastinal structures, causing pain, dysphagia, hoarseness, superior vena caval obstruction and atrial fibrillation. Juvenile xanthogranuloma in childhood and adolescence: a clinicopathologic study in 129 patients from the Kiel Pediatric Tumor Registry. Relationship between length of longitudinal extension and maximal depth of transmural invasion in roentgenographically occult squamous cell carcinoma of the bronchus (nonpolypoid type). Fibrosis in Grade 1 lesions, plus involvement of alveolar ducts and two or more tiers of alveoli adjacent to the bronchiole with some spared alveoli between adjacent bronchioles. The mesenchymal cells are positive for vimentin, musclespecific actin, and sometimes for desmin. In addition to the risk of life-threatening viral pneumonia and superimposed bacterial infections, these viruses (except for rhinovirus) have been associated with both acute and chronic rejection. Occasionally, the migrating worms cross the diaphragm and enter the pleura and lung. The term "thrombotic arteriopathy" conveniently covers both entities, avoiding the problematic distinction. The route of infection has not been determined, although inhalation seems more likely than direct inoculation. The sulfhydryl-rich membrane-coating granules deposit along the inner surface of the cell membrane prior to cell death and should not be confused with surfactant granules. Vascular remodeling versus vasoconstriction in chronic hypoxic pulmonary hypertension: a time for reappraisal Dissociation of pulmonary vascular remodeling and right ventricular pressure in tissue angiotensin-converting enzymedeficient mice under conditions of chronic alveolar hypoxia. Epstein-Barr virus-associated adrenal smooth muscle tumors and disseminated diffuse large B-cell lymphoma in a child with common variable immunodeficiency: a case report and review of the literature. Carcinomas exhibit the same abnormalities one finds in either squamous cell carcinoma or adenocarcinoma. Of note, one study found that vasculitis and necrosis were detected in 89% of open lung biopsies; granulomas and necrosis in 90%; and all three features, i. The changes are within intima and adventitia of veins, leading to fibrotic occlusion and recanalization.

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Histologically unique case of combined small cell and squamous cell carcinoma in a polypoid bronchial tumor. Single multinucleated histiocytic giant cells may sometimes be identified within this infiltrate. An adult case of lymphangiomatosis of the mediastinum, pulmonary interstitium and retroperitoneum complicated by chronic disseminated intravascular coagulation. Cerebral metastasis and other central nervous system complications of pleuropulmonary blastoma. This differential is critical in making the clinical decision between surgical management and chemotherapy. Lung transplantation for chronic obstructive pulmonary disease: special considerations. When they die, they often calcify and remain evident on imaging as small calcific deposits. Polymorphisms of matrix metalloproteinases 1, 2, 3 and 9 and susceptibility to lung, breast and colorectal cancer in over 30,000 subjects. Allelic losses at chromosome 8p21:23 are early and frequent events in the pathogenesis of lung cancer. Increased risk of fibrosing alveolitis associated with interleukin-1 receptor antagonist and tumor necrosis factor-alpha gene polymorphisms. Thromboembolic outcomes include recanalization and partial thrombus reabsorption while concentric medial hypertrophy through to plexogenic angiomatoid lesions can be seen. Bronchiolitis obliterans syndrome in lung transplant recipients is associated with increased neutrophil activity and decreased antioxidant status in the lung. Hyaline membranes have not been described in cases of chronic eosinophilic pneumonia. The initial combination usually includes rifampicin, isoniazid, pyrazinamide and either ethambutol or streptomycin. Those malignant lymphomas that are primarily node or bone marrow-based and involve the lungs secondarily are discussed separately, together with pulmonary involvement by leukemic processes. Table 2 Associations and causes of chronic eosinophilic pneumonia Allergic bronchopulmonary fungal disease109 Simple pulmonary eosinophilia90,91 Systemic infection (parasites, fungi)90,91 Connective tissue disease, esp. Mre11 expression in atypical adenomatous hyperplasia and adenocarcinoma of the lung. Large cell carcinoma Variants Large cell neuroendocrine carcinoma Combined large cell neuroendocrine carcinoma Basaloid carcinoma Lymphoepithelioma-like carcinoma Clear cell carcinoma Large cell carcinoma with rhabdoid phenotype Source: reference 2. Report From a consensus conference on the sensitized patient awaiting Heart transplantation. Granulomatous Pneumocystis carinii pneumonia in three patients with the acquired immune deficiency syndrome. The histological recognition of coccidioidal infection rests on the identification of the spherules. Severe pulmonary hypertension: a frequent complication of stem cell transplantation for malignant infantile osteopetrosis. Inorganic fibers in lung tissue from patients with pleural plaques or malignant mesothelioma. Morikawa N, Kuroda T, Honna T, Kitano Y, Fuchimotoa Y, Terawakia K, Kawasakib K, Koinumab G, Matsuokac K, Saekia M. The granulomas are composed of loose aggregates of multinucleated cells and epithelioid cells surrounding foreign material. This typically develops days to weeks after exposure and is typically rapidly fatal. The choice of sample to diagnose schistosomiasis depends on the species of parasite likely to be 325 Chapter 8: Pulmonary parasitic infections causing the infection. In addition, there were more differences between tumor and normal mucosa in ex-smokers. In such cases infection should be rigorously excluded by culture and molecular biological techniques, prior to attributing the cause to inflammatory bowel disease.

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The incidence of Kaposi sarcoma in renal transplant patients and its relation to immunosuppression. Pathologically, pre-acinar and intra-acinar pulmonary arteries and arterioles demonstrate grossly thickened walls due to an increase in vascular smooth muscle. Previous lung disease and risk of lung cancer among lifetime nonsmoking women in the United States. Limited experience from pediatric burn centers suggests pulmonary ascariasis, superimposed on smoke inhalation injury, reduces burn patient survival rates. These channels are normally collapsed and inconspicuous but are more prominent if there is pulmonary edema or they contain tumor. Pulmonary capillaritis: a possible histologic form of acute pulmonary allograft rejection. Pulmonary function tests may reveal a low diffusion capacity, desaturation with exercise, and airflow obstruction. Ventilatorassociated pneumonia complicating the acute respiratory distress syndrome. Niemann-Pick disease: sixteen-year follow-up of allogeneic bone marrow transplantation in a type B variant. This was because it was recognized that as well as showing a spectrum of histological features from cellular to fibrotic types, it was a pattern not uncommonly seen in other interstitial lung diseases, and that idiopathic cases were poorly characterized. These pneumonias usually afflict preterm infants on neonatal units towards the end of their first week of life. Acute respiratory distress syndrome can present before or after treatment in falciparum malaria and is nearly always part of a systemic sepsis-like syndrome with multi-organ failure. Clinical similarities and differences between human T-cell lymphotropic virus type 1-associated bronchiolitis and diffuse panbronchiolitis. Distribution and characteristics of amphibole asbestos fibres in the left lung of an insulation worker measured with the light microscope. Role of bacteria in the pathogenesis and progression of acute and chronic lung infection. Pulmonary venoocclusive disease: involvement of pulmonary arteries and review of the literature. Some of the agents that can produce this reaction may be administered in the context of an immunosuppressed state, so the coexistence of infectious agents should always be considered. Atypical adenomatous hyperplasia is common in lungs bearing primary adenocarcinoma. Collapsed nasal structures and skin destruction were not uncommon findings in the era before effective medical treatment. In asymptomatic patients with bilateral tumor nodules, "watchful waiting" has been proposed in order to avoid therapeutic side effects. Special clinical features In contrast to synovial sarcomas from more conventional sites which occur primarily in younger patients with a male predominance, primary pulmonary synovial sarcomas occur in an older age group, with a mean age of 42 years. When illuminated by blue/ violet light, normal bronchial mucosa fluoresces strongly in green, while premalignant and malignant tissues have significantly lower green autofluorescence. Serum dysproteinemias occur in up to 80% of patients, usually as a polyclonal hypergammaglobulinemia. Mortality experience of insulation workers in the United States and Canada, 1943:1976. The influence of cigarette smoking on lung function in patients with idiopathic pulmonary fibrosis. Natural history of pure ground-glass opacity after longterm follow-up of more than 2 years. It is unclear whether this is directly related to the yeast or whether other co-species are involved. Muscle strength improves with exercise but not with anticholinesterase administration. Basal cell hyperplasia has been discussed as a likely important precursor for the subsequent development of dysplasia. Multiple suspicious lesions detected by autofluorescence bronchoscopy predict malignant development in the bronchial mucosa in high risk patients. Desquamative interstitial pneumonia-like areas and eosinophil-rich areas have also been described in some cases, although these have no prognostic significance. Although the degree of fibrosis tends to correlate with radiographic evidence of size reduction, radiological evidence of size regression does not seem to significantly correlate with the degree of histological tumor response.

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Electron microscopy the ultrastructural features of the spindle cells resemble smooth muscle cells. Sagittal reformatted multislice computed tomogram demonstrates a right main bronchus mass with right lower lobe bronchiectasis. Cytology Percutaneous fine-needle aspiration biopsy demonstrates sheets and individual bland spindle cells. Immunohistochemistry in the distinction between malignant mesothelioma and pulmonary adenocarcinoma: a critical evaluation of new antibodies. However, this treatment does not prevent the major causes of morbidity and mortality, namely alveolar proteinosis and/ or renal disease. In these instances, the acute effect was not sufficient to directly cause lung cancer. The statistical odds of the correct number and order of mutations and other alterations in gene expression occurring in a cell population which remains viable are hard to quantify but are undoubtedly enormous. Loss of Fhit expression in non-small-cell lung cancer: correlation with molecular genetic abnormalities and clinicopathological features. Inflammatory myofibroblastic tumor versus IgG4-related sclerosing disease and inflammatory pseudotumor: a comparative clinicopathologic study. In addition, the glottis prevents macroaspiration, but small amounts of microaspiration are normal. Liver abnormalities Liebermeister grooves are grooves on the superior and anterior surface of the right lobe of the liver, which correspond to the muscle arrangements of the diaphragm and intercostal spaces. Specific identification can be achieved by immunohistochemistry using monoclonal antibodies. Pyoderma gangrenosum Pyoderma gangrenosum is an uncommon condition of unknown etiology, which typically presents as rapidly developing cutaneous ulcers often associated with fever. Coates and Watson276 identified tungsten carbide, cobalt and titanium in lung tissue of tungsten carbide workers with interstitial fibrosis by mass spectroscopy. Use of pleural fluid levels of adenosine deaminase and interferon gamma in the diagnosis of tuberculous pleuritis. In non-immunocompromised persons, ascariasis, schistosomiasis, paragonimiasis and hydatid disease are the commonest parasitic agents of clinical lung disease. This chapter aims to elucidate the epidemiological, etiological and clinical aspects of lung cancer. Effects of phenolics in Empire apples on hydrogen peroxide-induced inhibition of gap-junctional intercellular communication. Birefringent particles are observed with polarized light microscopy within giant cells, within macrophages, or free in the interstitium. In addition, the mixed adenocarcinoma subtype is replaced with a system that classifies carcinomas according to the predominant architectural pattern. De novo production of K-alpha1 tubulin-specific antibodies: role in chronic lung allograft rejection. Interest in the pathological effects of zeolites can be largely attributed to the discovery of an epidemic of malignant pleural mesothelioma in two small villages in the Anatolian region of Turkey. Comparison of in situ hybridization and immunohistochemistry for detection of cytomegalovirus and herpes simplex virus. Humans or other animals can become infected if they ingest soil containing Toxocara eggs. The latter occurs mainly in Japan, and is usually associated with chronic sinusitis. Defects in the latter may allow the development of invasive aspergillosis, which is a life-threatening condition in advanced disease. These advances have greatly increased our ability to recognize, distinguish and investigate this spectrum of neoplasms and have supplanted earlier, more capricious histochemical methods of detection. Marked goblet cell hyperplasia with mucus accumulation in the airways of patients who died of severe acute asthma attack. Obstructive uropathy secondary to ureter or prostate involvement are also rare occurrences. Pleural retraction and intratumoral air-bronchogram as prognostic factors for stage I pulmonary adenocarcinoma following complete resection. Rituximab is effective in the treatment of refractory Churg-Strauss syndrome and is associated with diminished Tcell interleukin-5 production.

Diseases

• Goltz syndrome
• Scleredema
• Ludomania
• Focal alopecia congenital megalencephaly
• Idiopathic pulmonary haemosiderosis
• Tuberous Sclerosis, type 1
• Diphtheria
• Trismus pseudocamptodactyly syndrome
• Diabetes mellitus type 2
• Macular dystrophy, vitelliform

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Pathological and biochemical abnormalities in the neural and mesenchymal elements of the brain. They are most frequent in adult males, particularly in smokers or workers exposed to asbestos or anthracotic dust. A practical way of approaching the worm infections is a morphological sieve-by-size. Initial pathological studies suggested that the most common pulmonary manifestation was apical fibrobullous disease, occurring in about 1% of patients (Table 9). One alveolar adenoma demonstrated microsatellite and loss of heterozygosity alterations only in the epithelial component. Coarse particles comprise 90:95% of the total suspended mass but the smaller particles are more numerous. Solitary atypical adenomatous hyperplasia in the lung of a 17-yearold man with spontaneous pneumothorax. Diagnosis Most hydatid cysts are diagnosed on clinical suspicion, imaging and serology. The caliber of pulmonary veins is normal, while mediastinal lymph node enlargement is seen in some patients. Involvement of mediastinal structures, such as the superior vena cava, is often evident. It is relatively easy to visually divide a thickened stratified epithelium into upper, middle and lower zones for assessment of the distribution of the changes indicated in Table 3. When its expression is experimentally re-established in renal tumor cell lines, this has a suppressive influence on the tumor, including colony formation in vitro and slower establishment of tumors in mouse xenografts. Response of pulmonary artery intimal sarcoma to surgery, radiotherapy and chemotherapy: a case report. Moderately cellular aspirates feature flat sheets to three-dimensional cohesive spheres and irregular aggregates of cells with sharply defined borders. Together with a diffuse increase in background pigmentation, lesions impart a black appearance to the lung tissue. Two reports identified a neutrophilic capillaritis as a component of the injury pattern. These processes result in alteration of the elastic layers, often with reduplication. Pulmonary artery disease shows little correlation with the systemic pattern of arterial involvement,406,422,423and is rarely the presenting manifestation. This peculiar condition is characterized by tuberculous lymphadenopathy causing bronchial obstruction and atelectasis. Since these carcinomas arise from respiratory mucosa, it is frequent to find airway wall involvement and architectural destruction of surrounding lung parenchyma. Immunohistochemical and ultrastructural markers suggest different origins for cuboidal and polygonal cells in pulmonary sclerosing hemangioma. Immunohistochemical detection of cluster 1 small cell lung cancer antigen and chromogranin A in lung carcinomas. These conditions do not exhibit a monotonous sheet of cells, and typically have an associated variable, mixed inflammatory infiltrate. In contrast, in Idiopathic pulmonary fibrosis and usual interstitial pneumonia Idiopathic pulmonary fibrosis (previously termed cryptogenic fibrosing alveolitis (see above)) is the clinical term for a relatively uncommon fibrosing lung disease, with an estimated prevalence of 7:20/100 000. Significance of p63 amplification and overexpression in lung cancer development and prognosis. As there tends to be a fair amount of overlap in the pathological response to smoking marijuana and tobacco, separating the two can be difficult. In this group, antigenuria can be detected in about 75% of cases, provided samples are obtained within 2 weeks after exposure.

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Investigations should cover possible microbial etiologies, markers of illness severity, including measures of renal function and gas exchange, and markers of underlying disease, such as a chest radiograph to exclude underlying lung cancer. Pulmonary leiomyosarcoma and primary pulmonary leiomyoma both form discrete tumor masses, and are not characterized by cyst formation. Since hyper-proliferating epithelia are more likely to undergo malignant transformation, cell division seems to be a prerequisite for some of the genetic lesions required for the malignant genotype. With enhancement, the peripheral zone of the mass is strongly enhanced and the central zone enhances poorly. Mucocutaneous-lymphangitis paracoccidioidomycosis might be the result of direct inoculation. Parkin, a gene implicated in autosomal recessive juvenile parkinsonism, is a candidate tumor suppressor gene on chromosome 6q25-q27. Chronic berylliosis is the most common of these rarities and is almost always caused by repeated or longstanding environmental exposure to beryllium (see Chapter 14). Pulmonary chondroma: a tumor associated with Carney triad and different from pulmonary hamartoma. Following transplantation extended ventilatory requirements, line placements, nutritional problems and diminished ambulation contribute to the development of infections. Actuarial survival of heart-lung and bilateral sequential lung transplant recipients with obliterative bronchiolitis. Pulmonary morphology in a multihospital collaborative extracorporeal membrane oxygenation project. Inflammatory bronchial polyps associated with asthma: resolution with inhaled corticosteroid. Injury to endothelium, alterations in normal blood flow and alterations in the blood (hypercoagulability) predispose to thrombosis. It exhibits both a clinical and a morphological spectrum which in its severe form is characterized by acute hypoxemic respiratory failure, diffuse pulmonary infiltrates on radiographs and diffuse alveolar damage in lung biopsy specimens. Parenchymal consolidation, although historically associated with lepidic growth, is a rare presentation for even invasive adenocarcinoma. Thyroid transcription factor-1 and cytokeratins 7 and 20 in pulmonary and breast carcinoma. Comparison of microscopical examination and seminested multiplex polymerase chain reaction in diagnosis of Plasmodium falciparum and P. Hyper- and hypodiploidy are almost always present while the mean chromosome number is nearly triploid. Aberrant p16 methylation is an early event in pulmonary non-small cell carcinogenesis, particularly adenocarcinomas, leading to loss of both p16 activity and expression (see Chapter 22). Lesions are composed of loose masses of inflammatory and connective tissue cells within a collagenous and proteoglycan matrix. The latter condition has a dense appearance, with layers of compacted eosinophils and epithelial cells. Influence of sex on lung cancer histology, stage, and survival in a midwestern United States tumor registry. Acute fibrinous and organising pneumonia: a histological pattern of lung injury and possible variant of diffuse alveolar damage. Giant cell interstitial pneumonia in two hard metal workers: the role of bronchoalveolar lavage in diagnosis. The mesenchymal cells also show nuclear/cytoplasmic expression, which decreases in intensity in better differentiated cells. It is difficult to estimate their prevalence, but the literature indicates that about 20% of morphologically non-neuroendocrine pulmonary tumors have covert features of neuroendocrine differentiation. Ninety percent of visceral leishmaniasis cases occur in parts of India, Bangladesh, Nepal, Sudan, Ethiopia and Brazil, while 90% of cutaneous leishmaniasis cases occur in parts of Afghanistan, Algeria, Iran, Saudi Arabia, Syria, Brazil, Colombia, Peru, Bolivia and East Africa. The effects of hypoxia on markers of coagulation and systemic inflammation 655 Chapter 17: Chronic obstructive pulmonary disease and diseases of the airways in patients with chronic obstructive pulmonary disease.

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Micropapillary lung adenocarcinoma: a distinctive histologic subtype with prognostic significance. Fungi causing pulmonary granulomas include Pneumocystis jiroveci, histoplasma, cryptococcus, blastomyces, coccidioidomyces, South American blastomyces, adiospiromyces and sporothrix (see Chapter 7). Recurrent bronchioloalveolar carcinoma after lung transplantation: radiographic and histologic features of the primary and recurrent tumors. Of note, stroma-rich, epithelium-poor pulmonary endometriosis has also been reported (see differential diagnosis section below). Although it may not always be possible to determine the bacterial species by histology, the findings may direct further definitive testing. The circumscribed adenocarcinoma has a glistening mucoid appearance with obvious parenchymal destruction. Neuroendocrine cell hyperplasia and obliterative bronchiolitis in patients with peripheral carcinoid tumors. These findings are associated with chronic respiratory compromise (see Chapter 9). Cysts not readily identifiable in an expanded lung may be more readily seen in a deflated lung, caused by pneumothorax. Lobectomy is required when anatomically limited surgery is not technically feasible or when the lung distal to the tumor is extensively damaged. The organisms are present in the environment and usually affect the lung as a disseminated infection, but inhalation does occur. Most cases are due to a single species Legionella pneumophila and serogroup 1 of this species accounts for 95% of cases. Approximately 20% of cases are associated with an underlying malignancy, often hematological. The airspaces are filled with plugs of organizing immature fibroblastic tissue comprising myofibroblasts and loose matrix elements. Subsequent reports have largely confirmed that this early presentation is typical and presentation after 6 months rare. Accuracy of clinical diagnosis of acute respiratory distress syndrome in comparison with autopsy findings. The differences in severity are due primarily to various mutations, some of which permit residual enzyme activity. Heroin is manufactured by acetylating morphine with acetic acid to produce diacetylmorphine, or heroin. Histological features include a vigorous mixed inflammatory infiltrate within affected cartilage, consisting of lymphocytes, macrophages, plasma cells and eosinophils (Table 10). With increased use of improved imaging modalities, one wonders whether greater numbers of this lesion will be seen. Integration of human papillomavirus type 11 in recurrent respiratory papilloma-associated cancer. In patients with leukemia or widespread lymphoma, they may be involved together with other intrathoracic nodes. Small cell carcinoma must be differentiated from pulmonary blastoma, especially when a small biopsy sample contains only blastema-like cells. In addition to dense interstitial and intra-alveolar infiltrates there are alveolar fibrinous exudates and hyaline membranes. The cytological hallmarks of reactive atypia include bizarre nuclei with preserved nuclear/cytoplasmic ratios. Diffuse pulmonary hemorrhage syndromes in addition to rheumatoid nodules and bronchocentric granulomatosis should also be considered. Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis. Lung cancer mortality trends in 36 European countries: secular trends and birth cohort patterns by sex and region 1970:2007. Neuroendocrine differentiation in poorly differentiated lung carcinomas: a light microscopic and immunohistologic study. Blebs are collections of air within the visceral pleura that probably result from rupture of subpleural alveoli. Glutathione:Stransferases are critical enzymes, involved in the detoxification and inactivation of reactive oxygen and nitrogen species.

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In more severely ill patients intubation and assisted ventilation may be necessary. The third stage develops in these molluscs but crabs, crayfish and fish may all be infected. Costophrenic angle obliterations are recorded as present or absent, with designation as to side involved. Cells growing in a so-called "picket fence" type pattern or the formation of true papillae 3. Their main clinical pathology is lymphatic filariasis, as adult worms reside in lymph node sinuses. If untreated, the infection spreads along lymphatics, causing a chronic, slowly progressive lymphocutaneous reaction. Bronchoalveolar lavage cellularity: lone cryptogenic fibrosing alveolitis compared with the fibrosing alveolitis of systemic sclerosis. Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non-smokers. Thoracic involvement of systemic lupus erythematosus: clinical, pathologic, and radiologic findings. Bronchoscopic and bronchographic findings in 12 patients with sarcoidosis and severe or progressive airways obstruction. Progressive massive fibrosis of the lung secondary to intravenous injection of talc. Many other entities, including but not limited to pulmonary infections, interstitial lung diseases such as sarcoidosis/necrotizing sarcoid granulomatosis and Langerhans cell histiocytosis, pulmonary hypertension, drugs, transplantation, radiation, systemic processes including connective tissue disease and inflammatory bowel disease, and malignancies, especially lymphoproliferative disorders such as lymphomatoid granulomatosis, cause pulmonary vasculitis and/or hemorrhage. Patients with salivary gland lung tumors are, on average, younger than other bronchogenic carcinoma patients. Two-thirds of the incorrect frozen section diagnoses are considered false negatives, while only one-third are false positives. A peculiar tendency for colocalization of overexpressed b-catenin and neuroendocrine markers in the same cells has been reported in pulmonary blastoma. Redefining the clinical spectrum of chronic pulmonary histoplasmosis: a retrospective case series of 46 patients. By definition light microscopic evidence of neither glandular or squamous differentiation is seen. Fewer cases are due to venous obstruction at the level of the large pulmonary veins. Flock workers lung: broadening the spectrum of clinicopathology, narrowing the spectrum of suspected etiologies. The adult paired male and female worms, 6 to 26 mm long and up to 1 mm wide, live for 3 to 5 years, although occasionally for more than 20 years. There is obvious nuclear atypia including hyperchromatism, prominent nucleoli and mitoses. There is also the potential for bystander exposure in individuals who work in facilities that use beryllium but do not handle the metal itself. Pulmonary blastoma in a neonate: a lesion distinct from pleuropulmonary blastoma with unique cytogenetic features. Rudner Drug-induced lung disease represents one of the more challenging areas of pulmonary medicine from both a clinical and pathological standpoint. A positive sputum culture from a patient with severe neutropenia is suggestive of invasive disease. Marked fibrosis is uncommon, although rare examples where there is focal or sub-total sclerosis with marked thickening of the alveolar walls may be encountered. Stringent oversight of workplace conditions and permissible exposures on the part of governments and regulatory agencies, along with the retention of occupational health physicians on the part of larger firms, will hopefully mitigate the development of severe disease in the future. Sarcoma of the pulmonary artery: report of two cases and a review of the literature. Influence of panel-reactive antibodies on posttransplant outcomes in lung transplant recipients. Since this is a migrating larva, worms can end up in ectopic non-pulmonary locations. Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection.