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肺胸膜表面可见乳腺癌转移灶。可引起胸腔积液,包括出血性的渗出物,并且胸水细胞学检查可见癌细胞。

A focus of metastatic carcinoma from breast is seen on the pleural surface of the lung. Such pleural metastases may lead to pleural effusions, including hemorrhagic effusions, and pleural fluid cytology can often reveal the malignant cells.

图示间皮瘤,致密的白色环状肿块从胸膜脏层长出。一些大的肿块能充满胸腔。间皮瘤危险因素是接触石棉。相反在接触石棉的人中间皮瘤很少见。石棉肺易引起支气管癌,它使患癌的风险增大5倍。吸烟使患肺癌的风险增大10倍。因此,具有石棉接触史的吸烟者患肺癌风险增大了50倍。

The dense white encircling tumor mass is arising from the visceral pleura and is a mesothelioma. These are big bulky tumors that can fill the chest cavity.The risk factor for mesothelioma is asbestos exposure. However, mesothelioma is rare even in persons with asbestos exposure. Asbestosis more commonly predisposes to bronchogenic carcinomas, increasing the risk by a factor of five. Smoking increases the risk for lung cancer by a factor of ten. Thus, smokers with a history of asbestos exposure have a risk 50 fold greater likelihood of for developing lung cancer.

图示间皮瘤内既有梭形细胞又有饱满的圆形细胞,二者形成类似腺体的外形。在细胞学上很难诊断。

Mesotheliomas have either spindle cells or plump rounded cells forming gland-like configurations, as seen here at high power microscopically. They are very difficult to diagnose cytologically.

图示引起石棉肺的因素,长而薄的物质是石棉纤维。许多房子和办公室仍然使用含石棉的建筑材料构建,特别是用于绝缘,因此在对建筑物进行改造或重建时对石棉一定要引起注意。

This is the causative agent for asbestosis. This long, thin object is an asbestos fiber. Many houses and offices still contain building materials with asbestos, particularly insulation, so care must be taken when doing remodelling or reconstruction.

石棉纤维被铁和钙包裹,这就是采用铁染色法染色发现含铁体的原因。当这些纤维被巨噬细胞吞噬时会发生纤维增生反应,此反应通过成纤维细胞释放能促进胶原沉积的生长因子来实现。

The asbestos fiber becomes coated with iron and calcium, which is why it is often referred to as a "ferruginous body" as seen here with an iron stain. Ingestion of these fibers by macrophages sets off a fibrogenic response via release of growth factors that promote collagen deposition by fibroblasts.

尘肺的又一典型的大体损害,尤其石棉肺,引起纤维性胸膜斑。可见几个呈灰白色的胸膜斑。

Another gross lesion typical for pneumoconioses, and asbestosis in particular, is a fibrous pleural plaque. Seen here on the pleural side of the diaphragmatic leaves are several tan-white pleural plaques.

镜下纤维性胸膜斑由数层致密的胶原纤维组成。

Microscopically, the fibrous pleural plaque is composed of dense layers of collagen.

图示肺矽结节。它主要由成束相互交织的粉红色胶原纤维组成。此处炎症反应轻。暴露于二氧化硅的强度越大,暴露时间越长,决定了矽肺结节的数目及肺疾病的发展。矽肺使肺癌的风险增加了2倍。

A silicotic nodule in lung is seen here. It is composed mainly of bundles of interlacing pink collagen. There is a minimal inflammatory reaction. The greater the degree of exposure to silica and increasing length of exposure determine the amount of silicotic nodule formation and the degree of restrictive lung disease. Silicosis increases the risk for lung carcinoma about 2-fold.

煤肺色素通常不存在纤维化,但炭尘量很大(就如煤矿工人的 “黑肺病”),纤维增生反应能诱发煤矿工人肺尘埃沉着症。

Anthracotic pigment ordinarily is not fibrogenic, but in massive amounts (as in "black lung disease" in coal miners) a fibrogenic response can be elicited to produce the "coal worker's pneumoconiosis" seen here.

偏振光显微镜可见大多数尘肺的病原(甚至对于那些煤矿工人)--二氧化硅晶体。图示为大小不一的亮白色晶体。巨噬细胞吞噬二氧化硅诱发纤维组织增生,产生胶原纤维沉积结节。

By polarized light microscopy can be seen the etiology for most pneumoconioses (even those in coal miners)--silica crystals. Here are seen bright white crystals of varying sizes. The silica induces a fibrogenic response by macrophages to produce the nodular foci of collagen deposition.


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