General Pathology

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

Pigments Definition: colored substances in the organism or environment

Pigments Classification: • endogenous • hemoproteins derived • autogenous • exogenous

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

Exogenous Pigmentation • traumaticorigin – tatuatio traumatica, arteficialis • gastrointestinal tract – intoxicatio Pb, Ag, Au, Fe (!)

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

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

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

Exogenous Pigmentation • gastrointestinal 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 coal-like 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) • progression even after exposure elimination • part of miners disease • affinity to other lung diseases (tbc)

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

Silicosis Pathogenesis: toxic activity of quartz dust to macrophages • production of PDGF1, IGF-1, fibronectin • chemotaxins, IL-8 • enzyme activation, • lung injury, inflammation, • FIBROSIS

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

Coal Workers Pneumoconiosis - CWP • Coal macules- dust laden macrophages • Coal nodules – mild collagen admixture Advanced • 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 • chrysotile (90%), amosite, croccydolite etc.

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

General Pathology