课件：呼吸系统常见疾病.ppt

* 07/16/96 * ## * 07/16/96 * ## This photomicrograph demonstrates a bronchus with increased numbers of chronic inflammatory cells in the submucosa. Chronic bronchitis does not have characteristic pathologic findings, but is defined clinically as a persistent productive cough for at least three consecutive months in at least two consecutive years. Most patients are smokers. Often, there are features of emphysema as well. * 07/16/96 * ## The lumen of the bronchus is above. Note the marked thickening of the mucous gland layer (approximately twice normal) and squamous metaplasia of lung epithelium. * 07/16/96 * ## This is an acid fast stain of Mycobacterium tuberculosis (MTB). Note the red rods--hence the terminology for MTB in histologic sections or smears: acid fast bacilli. * 07/16/96 * ## Mycobacteria can also be stained with auramine and viewed with fluorescence microscopy, in which acid fast bacilli now appear as glowing yellow rods. This method is easier to use to screen for mycobacteria and is the method routinely used in sputum specimens sent to the laboratory. * 07/16/96 * ## * 07/16/96 * ## At high magnification, the granuloma demonstrates that the epithelioid macrophages are elongated with long, pale nuclei and pink cytoplasm. The macrophages organize into committees called giant cells. The typical giant cell for infectious granulomas is called a Langhans giant cell and has the nuclei lined up along one edge of the cell. The process of granulomatous inflammation takes place over months to years (did you ever hear of a committee action that was completed in a short time?) * 07/16/96 * ## Well-defined granulomas are seen here. They have rounded outlines. The one toward the center of the photograph contains several Langhans giant cells. Granulomas are composed of transformed macrophages called epithelioid cells along with lymphocytes, occasional PMNs, plasma cells, and fibroblasts. The localized, small appearance of these granulomas suggests that the immun