病理学英文版课件_传染病co_mmunicable_disease_.pptVIP

Chapter 15 communicable disease ;;Pathology of Tuberculosis Overview Pulmonary tuberculosis Extra-pulmonary tuberculosis ;; WHO 1995 ;;;;World TB Day 2004 Every Breath Counts Stop TB Now!;Directly observed therapy shortcourse; Etiological factor and pathogenesis ;;;M. tuberculosis (air) M. bovis (milk) Aerobic, no toxins, no spore, non motile Mycolic acid in bacterial wall - Acid Alcohol fast (AFB);;;;;; Caseous necrosis Gross: yellow、delicate、like cheese Microscopy: coagulative necrosis Prognosis: fibrosis Liquefaction Absorption;;;; Tuberculous Granuloma ： Gross：0.1mm、grey 、translucent Microscopy ：caseous necrosis、 epithelioid cells 、 langhans giant cells 、 lymphocytes, plasma cells, and fibroblasts. Prognosis ： fibrosis ;;;;; Fundamental Prognosis Healing absorption、resolution fibrosis、calcification; Progressive infiltration： dissemination： lymphatic pathway：first hematogenous pathway：first airway：second ; ; Primary Tuberculosis ;In Non Immunized individuals (Children) Primary Tuberculosis: Children-type,intial infection Primary complex Self Limited disease,95% Primary Progressive TB(5%) 10% of adults, Immunosuppressed individuals Common in malnourished children Miliary TB and Meningitis.;Primary complex the lower part of the upper lobe or the upper part of the lower lobe 1-1.5cm area of gray-white tuberculosis lymphangitis hilar lymphonode tuberculosis ;Primary Complex;;Secondary Tuberculosis;Post Primary in immunized individuals. Adult-type;reactivation or reinfection Apical lobes or upper part of lower lobes Caseation, cavity ,granuloma Pulmonary or extra-pulmonary Local or systemic/Miliary ; Local-type infiltration-type chronicity-type