1、Confluent consolidation of all or the majority of a lobe of the lung 灰色肝样变期灰色肝样变期灰色肝样变期灰色肝样变期(低倍低倍)溶解消散期图注:大叶性肺炎肉质变肺泡腔内充以纤维组织,肺泡间隔完好。好发年龄联系病变性质病变范围病因并发症预后acute fibrino-purulent exudative pneumonia by which there is a mixture of neutrophils and macrophages,within a background fibrinous exudate 肺泡间隔增宽
2、明显,毛细血管及小血管扩张充盈。增宽的间隔内大量的淋巴、单核及浆细胞浸润。肺泡腔内渗出物不明显。hyaline membranes流感病毒、麻疹病毒和腺病毒引起,肺泡腔内渗出的浆液性渗出物浓缩成红染的膜状物贴附于肺泡内表面病毒包涵体病毒包涵体 呈球形,约红细胞大小,呈嗜酸呈球形,约红细胞大小,呈嗜酸/嗜碱性染色,嗜碱性染色,均质或细颗粒状,其周围常有一清晰的透明晕均质或细颗粒状,其周围常有一清晰的透明晕图注:腺病毒性肺炎肺泡间隔增宽,毛细血管扩张充盈,单核细胞浸润。肺泡腔内单核细胞渗出,肺泡上皮细胞增生。图中央可见增大的肺泡上皮细胞核内圆形、红染的核内病毒包涵体Chest radiograph
3、s of index patient with severe acute respiratory syndrome(SARS).a,day 5 of symptoms;b,day 10;c,day 13;d,day 15.严重急性呼吸综合征严重急性呼吸综合征SARS的肺部病变:肺泡腔内充满大量脱落的肺泡上皮细胞及渗出的单核细胞、淋巴细胞,边缘见残存的透明膜。左上角示肺静脉管壁纤维素样坏死伴腔内血栓形成凡事都得趁早图注:慢性支气管炎支气管纤毛柱状上皮结构消失,代之为鳞状上皮,但细胞排列紊乱。管壁淋巴细胞浸润,血管扩张。-hyperplasia of the mucus glands.-thick
4、ening of the basement membrane病理变化Bronchiectasis.Dilated bronchus in which the mucosa and wall is not clearly seen because of the necrotizing inflammation(Bullous emphysema)杵状指Silicosis,nodule,lung the confluence of whorled,hyalinized,fibrous nodules 期矽肺并发肺心病两肺坚实能竖立,胸膜增厚。右心显著肥大、扩大,心尖由右心构成 慢性肺源性心脏病两肺
5、胸膜广泛性纤维性增厚,左肺上叶前段肺叶见肺大泡;左肺下叶被肥大转位的心脏压迫萎陷,右心室前壁肺动脉圆锥显著膨隆 鼻咽泡状核细胞癌癌细胞境界不清,呈合体状,核大圆形,染色质少,呈空泡状,含1至2个肥大的核仁,癌细胞间有淋巴细胞浸润鼻咽未分化癌癌细胞呈短梭形,核卵圆,浓染,呈燕麦细胞型癌结构图注:中央型肺癌图注:周围性肺癌弥漫性肺癌图注:高分化型鳞状细胞癌。Bronchioloalveolar carcinoma is a variant of adenocarcinoma.In this picture it resembles pneumonia.Bronchioloalveolar carcinoma The arrows point to linear arrangements of neoplastic cells.Tumor cells line alveolar walls.Note that the tumor cells here are larger and more hyperchromatic than the normal bronchiolar epithelium of the airway at the lower left.图注:肺小细胞癌图注:肺大细胞癌