General Pathology Basic Principles of Cellular and Organ

General Pathology Basic Principles of Cellular and Organ Pathology Exogenous Pigments Jaroslava Dušková Inst. Pathol. , 1 st Med. Faculty, Charles Univ. Prague

Pigments Definition: colored substances in the organism or environment

Pigments Classification: u endogenous hemoproteins derived – autogenous exogenous – u

Exogenous Pigments - colored substances entering the organism via v v v traumatic lesions gastrointestinal tract respiratory tract

Exogenous Pigmentation v traumatic origin – tatuatio traumatica, arteficialis v gastrointestinal tract – intoxicatio Pb, Ag, Au, Fe (!)

Exogenous Pigmentation v traumatic origin – tatuatio traumatica, arteficialis mechanic instilation of inert dyes (china ink) into the deep dermis

Tatuatio arteficialis - therapy u LASER = Light Amplification by Stimulated Emission of Radiation – low performance laser – biostimulation – high performance laser – destruction of pigmentation shifts – postinflammatory, melasma, tatoo u u u SURGERY / CRYOSURGERY COMBINATION COVER UP

Tatoo v inert – persistent v macrophage degraded v macrophage transported secondary lymph node pigmentation

Exogenous Pigmentation vgastrointestinal tract – intoxicatio Pb, Ag, Au, Fe (!)

Exogenous Pigmentation through Airways PNEUMOCONIOSES Def. : conditions or diseases elicited with dust particles inhalation (<5 )

Pneumoconioses – coniosis simplex (anthracosis, siderosis) – coniofibrosis (silicosis, asbestosis, coal workers disease, siderosis) – coniotoxicosis conioalergosis (byssinosis, berylliosis) organic dusts

Anthracosis Def. : pneumoconiosis caused by inert coallike dust (without quartz admixture) no symptoms = coniosis simplex 100% population prevalence

Silicosis Def. : pneumoconiosis caused by quartz dust with pronounced fibrosis response CONIOFIBROSIS long lasting exposition (20– 40 years) v progression even after exposure elimination v part of miners disease v affinity to other lung diseases (tbc) v

Silicosis Stages: – diffuse reticular fibrosis (often clinically silent) – silicotic nodules (+ perifocal emphysema) – massive fibrosis

Silicosis Pathogenesis: toxic activity of quartz dust to macrophages u production of PDGF 1, IGF-1, fibronectin u chemotaxins, IL-8 u enzyme activation, u lung injury, inflammation, u FIBROSIS

Silicosis Complications: pulmonary fibrosis pulmonary hypertension cor pulmonale Cause of death cardiorespiratory insuffitiency

Coal Workers Pneumoconiosis - CWP u u Coal macules- dust laden macrophages Coal nodules – mild collagen admixture Advanced u Combined silicosis & anthracosis complicated often with tbc

Asbestosis Def. : pneumoconiosis caused by Asbestos fibrils with pronounced fibrotising response CONIOFIBROSIS Asbestos fibrillar mineral with various forms and fibrogenic capacity v chrysotile (90%), amosite, croccydolite etc.

Asbestosis Pathogenesis: toxic influence due to fibrils size and concentration u fibrosis with feruginous bodies u hyalin pleural plaques u risk of mesotelioma and lung carcinoma u pleural effusions („mesot. in situ“ – Bedrosjan 2004) u other neoplasiae?

Pneumoconioses – coniosis simplex (anthracosis, siderosis) – coniofibrosis (silicosis, asbestosis, coal workers disease, siderosis) ----------– coniotoxicosis conioalergosis (byssinosis, berylliosis, …. )

Coniotoxicosis Conioalergosis Berylliosis • acute - toxic pneumonitis • chronic – non caseating granulomas Byssinosis – cotton dust Farmer´s lung – moldy hay, actinomycetes, Bird fanciers disease - bird dust