Page 393 - Concise Pathology for Exam Preparation ( PDFDrive )

378 SECTION II Diseases of Organ Systems

- Manifests with dyspnoea, hypercapnia and chest pain due to filling up of
alveoli with protein-rich fluid and formation of hyaline membrane
- Complete recovery may be seen
(ii) Chronic berylliosis
- Seen after 20 years or more of exposure
- Cell-mediated hypersensitivity reaction produces noncaseating granulomas

Q. Define cor pulmonale. Enumerate the types of cor pulmonale.
Ans. Cor pulmonale is dilatation (with or without hypertrophy) of right ventricle due to
a primary respiratory disorder.
• Hypertrophy is a feature of chronic cor pulmonale; whereas, dilatation dominates in
acute cor pulmonale.
• Pulmonary hypertension is the common link between heart and lung dysfunction.

Q. What is acute cor pulmonale? Discuss the clinical manifestations
of acute cor pulmonale.
Ans. Acute cor pulmonale usually follows acute massive pulmonary embolism, which is
sufficient enough to obstruct more than 60% of pulmonary circulation. It leads to acute
pulmonary hypertension, acute right ventricular dilatation and failure.

Q. Discuss the aetiopathogenesis and clinicopathological features
of chronic cor pulmonale.

Ans. Chronic cor pulmonale is defined as a combination of hypertrophy and dilatation of
the right ventricle secondary to pulmonary hypertension, which results from diseases of
lung, pulmonary circulation or thorax.

Aetiology
• Chronic obstructive pulmonary disease (COPD—including chronic bronchitis and em-
physema) are responsible for more than 50% cases of chronic cor pulmonale.
• Early onset of cor pulmonale is seen in patients with chronic bronchitis (blue bloaters).
• The onset of cor pulmonale is late in patients with emphysema (pink puffers).
• Increased pulmonary vascular resistance and pulmonary hypertension are the central
mechanisms in all cases of chronic cor pulmonale.

Clinical Features
• Dyspnoea, due to pulmonary hypertension, not relieved by sitting up.
• Dry cough
• Chest pain due to dilatation of the root of pulmonary artery
• Exercise-induced peripheral cyanosis
• Signs of overt right heart failure including peripheral oedema, raised jugular venous
pressure, tender hepatomegaly, cardiac enlargement, right ventricular third heart sound
and a gallop rhythm.

Q. Classify lung tumours. Briefly describe their aetiopathogenesis
and morphology.

Ans. Tumours of lung include
• Malignant epithelial tumours or carcinomas (which constitute 90–95% of lung
tumours)
• Bronchial carcinoids (which constitute 5% of all lung tumours)
• Mesenchymal and miscellaneous tumours (which constitute 2–5% of all lung tumours)

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