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Normal Histology of The Lung and Pathophysiology of COPD (T Year)
Normal Histology of The Lung and Pathophysiology of COPD (T Year)
COPD
Presented to
MBBS4-Year 2
Presented by
Dr Despina Moissidou (Histology)
Dr Demetrios Kanakis (Pathology) 14th of September 2016
Upper respiratory tract
Respiratory mucosa:
Warm and humidify air (blood vessels / mucous glands)
Trap particulates (ciliated cells)
Barrier to infection (mucus is eventually swallowed)
Alveolar lining:
Gaseous exchange (blood-air barrier)
Surfactant production (pneumocytes II)
Elastic recoil (elastic fibres)
Location of lung tumours in
relation to carina is
important in lung cancer
staging.
Histology of upper airways
- Olfactory epithelium:
- thicker than respiratory epithelium
- Bowman’s glands, which are pure
serous glands, below the epithelial
surface (production of odorant binding
protein)
- abundant nerve fibers originating
from olfactory receptor cells
converge and give rise to the olfactory
tract, providing the special sense of
smell
- absence of goblet cells
- Respiratory epithelium:
- thinner than olfactory epithelium
- many mucus-secreting glands
- no nerve fibers
- abundance of goblet cells
- After the nose and nasal cavity, the
air travels down the pharynx, which is
divided into the nasopharynx,
oropharynx, and laryngopharynx.
Trachea
Bronchi
Bronchioles
Alveoli
- As we continue down the respiratory tract, we enter
the trachea. Shown on the left panel is the trachea and
the major bronchi, which branch into segmental bronchi
and determine the bronchopulmonary segments.
- Histological slides of the trachea are shown below.
The bottom left panel exhibits the characteristic C-
shaped rings of hyaline cartilage (C). The rings are
joined posteriorly by bands of smooth muscle known as
trachealis muscle (T). Tracheal mucosa (M) and some
strands of longitudinal muscle (L) are also shown.
- The trachea is lined with respiratory epithelium
sitting on a thick basement membrane. The elastic layer
contains many longitudinally oriented elastic fibers. The
submucosa contains loose connective tissue and mixed
muco-serous glands.
-Continuing down the respiratory tract, the
trachea bifurcates into two main or primary
bronchi. Within the tracheal bifurcation is a
keel-shaped cartilage known as the carina.
Sudhakar NJ. Pipavath, Rodney A. Schmidt, Julie E. Takasugi, J. David Godwin. Chronic Obstructive Pulmonary
Disease: Radiology-Pathology Correlation; Thoracic Imaging; Volume 24; Number 3; August 2009
Emphysema - Classification
www.pathologyoutlines.com
Emphysema - Classification
Centriacinar (or centrilobular)
Affects proximal parts of acini
(formed by respiratory bronchioles)
Spares distal part of acinus
Upper lobes (especially apical
segments) more severely affected
Heavy smokers
Emphysema - Classification
Panacinar (or panlobular)
Uniform enlargement of acinus
(from level of respiratory bronchioles
to alveoli)
Lower zones, usually most severe at
the bases
α1-antitrypsin deficiency
Emphysema - Classification
Paraseptal
Predominantly affects the distal
part of the acinus
More strikingly located adjacent
to the pleura
Propensity to cause pneumo-
thorax (‘bullous emphysema’)
Adjacent to areas of scarring or
collapse
ww.library.med.utah.edu Sudhakar NJ. Pipavath, Rodney A. Schmidt, Julie E. Takasugi, J. David Godwin.
Chronic Obstructive Pulmonary Disease: Radiology-Pathology Correlation;
Thoracic Imaging; Volume 24; Number 3; August 2009
COPD - Complications
Respiratory failure: Condition in which not enough oxygen
passes from lungs into the blood or lungs can't properly
remove carbon dioxide from the blood
Pulmonary hypertension and Cor pulmonale
Cor pulmonale is failure of the right side of the heart
brought on by long-term high blood pressure in the
pulmonary arteries and right ventricle of the heart
Pulmonary arterial constriction (as a result of hypoxia),
endothelial dysfunction, remodeling of the pulmonary
arteries (smooth muscle hypertrophy and hyperplasia),
and destruction of the pulmonary capillary bed
COPD - Complications
Pneumonia
Pneumothorax
Depression
Muscle
wasting/cachexia
Thank you
for your attention!