Robbins Essential Pathology PDF - Lung and Upper Respiratory Tract

CHAPTER 10 Lung and Upper Respiratory Tract 175 Clncal Features....

CHAPTER 10 Lung and Upper Respiratory Tract 175 Clncal Features. Lung abscess usuay s assocaed w coug and    Granuomatous nlammaton and tssue damage. In addon copous amouns o ou-smeng, puruen, or sanguneous spuum; o smuang macropages o k mycobacera, e enanced occasonay, emopyss occurs. Spkng ever and maase are com- mmune response rggered by 1 ces aso produces ssue dam- mon. Abscesses occur n 10% o 15% o paens w broncogenc age and caseous necross. In many ndvduas, s response as carcnoma; us, wen a ung abscess s ound n an oder adu, e necon beore cncay sgnican ssue desrucon or - underyng carcnoma mus be consdered. Treamen ncudes an- ness occur, bu  ere are mmune deics due o agng or mmu- boc erapy and,  needed, surgca dranage. he underyng con- nosuppresson, e necon progresses and e ongong mmune don suc as obsr ucon aso needs o be addressed. O vera, e response resus n subsana ssue damage. moray rae s n e range o 10%. In e arge majory o oerwse eay ndvduas w an efecve T ce mmune response, e ony consequence o prmary ubercuoss Tuberculosis are sma oc o scarrng wn e ungs and ymp nodes. ese oc Tuberculous is a communicable infectious agent that causes dis- oten arbor vabe bac and may serve as a ndus or dsease reacva- ease in the setting of altered T-cell immunity. on a a aer me  os deenses wane. Uncommony, n paens wo Tubercuoss s caused by Mycobacterum tubercuoss and usuay ave nered or acqured deecs n T-ce mmuny, e na nec- nvoves e ungs, bu may afec any organ or ssue n e body. More on eads o progressve prmary tubercuoss. e ncdence o progres- an 2 bon ndvduas are neced wordwde (more an one rd o sve prmary ubercuoss s parcuary g n HIV-posve paens e word’s popuaon), w approxmaey 10 mon new cases and 1.5 w sgnican mmunosuppresson (.e., CD4+ T-ce couns beow mon deas per year. Tubercuoss lourses under condons o pov- 200 ces/μL). Because o an nadequae CD4+ T-ce response, neced ery, crowdng, and cronc debang ness. In e Uned Saes,  s a ssues n suc ndvduas oten ack caseang granuomas and conan dsease o oder adus, e urban poor, paens w AIDS, and members unusuay arge numbers o acd-as bac (nonreactve tubercuoss). o mnory communes. Dsease saes a mpar oca or sysemc Secondary tubercuoss (reacvaon ubercuoss) s e paern mmuny aso ncrease e rsk; ncuded among ese are dabees me- o dsease a arses n a prevousy senszed ndvdua wen os us, Hodgkn ympoma, scoss, cronc rena aure, manuron, deenses are weakened by agng or oer acqured acors, oten many acoosm, and mmunosuppresson. In some areas o e word, HIV decades ater e na necon. I aso may resu rom renecon, necon s e domnan rsk acor or e deveopmen o ubercuoss. eer because e proecon aforded by e prmar y necon as waned or because o exposure o a arge nocuum o vruen bac. Etology and Pathogeness. Mycobacera are sender rods a are acd- Waever e source o e organsm, ony a ew paens (