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21st European Congress of Pathology
Istanbul, Turkey, September 08-13, 2007
http://www.ecp2007istanbul.org/
Slide Seminar 14, September 12th
Interstitial lung diseases
Chairpersons: Mattia Barbareschi (Italy), Frederique Capron (France) |
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Case 1
Presented by: Dr. H. Tazelaar
Clinical History
54-year-old woman presented with marked coughing and severe pulmonary restriction. She had a history of allergies and mild asthma for 10 years. High resolution CT scan showed a diffuse peripheral fibrotic process without zonal predominance. Diffuse areas of mosaic attenuation and ground glass opacification with small centrilobular nodules were also identified. She underwent surgical lung biopsy.
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Diagnosis & discussion |
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Case 2
Presented by: Dr. M.N Sheppard, Dr. A. Nicholson
Clinical History
A 48-year-old male from Libya presented with inferior MI, followed by exertional chest pain. Found to have blocked RCA, complex lesion in LAD and severe stenosis in LCxA. Episode of possible contamination of oxygen cylinders during initial admission in Libya. Noted to have bilateral gound glass shadowing during assessment for CABG. Open lung biops during coronary bypass surgery.
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Diagnosis & discussion |
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Case 3
Presented by: Dr. W. Timens
Clinical History
Female, 63-year- old Crohn disease since 31 years. About 27 years ago resection of rectum and ileum ( with ilostoma) was performed . Since 4 years increasing lung problems with abnormal diffusion. On CT, interstitial fibrosis with honeycombing, mainly in lower lobes.Iin upper lobes abnormalities mainly in the periphery with additional micronodular pattern. Open lung biopsies were taken from the right lower lobe.
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Diagnosis & discussion |
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Case 4
Presented by: Dr. W. Timens
Clinical History
Female, 33-year-old. At age 30 retroperitoneal tumor, inoperable, with enlarged lymph nodes. In addition severe diffuse pulmonary problems with hypoxia and many ventricular extrasystoles. Provera ( progesterone) as anticonceptive with additional anti-estrogen theraphy . 3 years later decrase in size of abdominal tumor, no effect on progressive pulmonary problems. The same year double sided lung transplantation. Slides from explanted lung.
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Diagnosis & discussion |
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Case 5A and 5B
Presented by: Dr. F. Calabrese
Clinical History
A 19 year old male patient affected by high-risk anaplastic large cell lymphoma (first diagnosis at age 7) underwent allogenic bone-marrow transplant from an HLA-matched urelted donor at age 12 in complete remission of his underlying disease after 4 relapses. The myeloablative conditioning regimen was based on total irradiation (12 Gy), cyclophosfamide ( 120 mg/kg) and thiotepa ( 10mg/kg). GVHD prophylaxis was performed with the administration of rabbit polyclonal antilymphocyte serum and cyclosporin plus short methotrexate respectively before and after stem cell infusion. One month after transplantation the patient developed erythematous macules with the greatest concentration on his superior chest. From age 13 he presented dyspnea on exertion, wheezing and productive cough. Chest X-ray showed reticular shadow and lung function test showed a decrease of FEV1 ( 42%) with a progressive worsening . The HR-CT of chest presented a mosaic pattern. Transbronchial biopsy (TBB) was performed at age 16. Due to progressive lung dysfunction, bilateral lung transplantation was performed at age 17. The patient is currently alive, discharged home.
A: TTB
B:Lung sections from native lungs.
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Diagnosis & discussion |
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Case 6
Presented by: Dr. A. M. Fernandez
Clinical History
52-year-old woman with a long history o moderate respiratory failure. After three years of illness, she was diagnosed by an open lung biopsy. On the radiographies she showed a bilateral diffuse reticular pattern with cystic air spaces . On HRCT, there wer mltiple thinwalled cyst, of variable size in diameter, irregularly distributed throughout the lungs.
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Diagnosis & discussion |
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Case 7
Presented by: Dr. A. M. Fernandez
Clinical History
38-year-old man. Cigarette smoker (20 cigarette/day). He presented severe dyspnea, non-productive cough and several low fever episodes. On radiographies, there were bilateral multiple nodules, some of them varying degrees of cavitation.
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Diagnosis & discussion |
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Case 8
Presented by: Dr. D. Yilmazbayhan
Clinical History
53-year old woman. Chest pain, haemopthysis, cough, fever; nodular lesion on CT scan, PPD 25mm, ARB negative; diagnostic biopsy performed. Lung upper lobe wedge resection material (10x4x2cm) , in the cut surface nodular lesions with irregular borders and cavitation were seen.
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Diagnosis & discussion |
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