Golden Yellow Consolidation at autopsy of Lung - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-27-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 512
Threads: 57
Thanked 318 Times in 163 Posts
Reputation: 328
Lungs Golden Yellow Consolidation at autopsy of Lung

At autopsy, a 60-year-old man is found to have a peripheral 7 cm area of golden-yellow consolidation on sectioning of the left lung. Microscopically, this area has alveoli filled with foamy macrophages. Which of the following conditions involving his lung is most likely to be responsible for this finding?

A Mycoplasma pneumoniae infection

B Cystic fibrosis

C Adenocarcinoma

D Silicosis

E Squamous cell carcinoma

F Malignant mesothelioma

G Thromboembolism
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulaziz (10-15-2011), Amenah (10-15-2011), cardio10 (07-28-2011), docusmle9 (07-27-2011), jahn77 (07-27-2011), m82_ghasemi (10-12-2011), MedicalExaminer (10-12-2011), struggle (07-28-2011)



  #2  
Old 07-27-2011
dr.Irina's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 229
Threads: 6
Thanked 68 Times in 61 Posts
Reputation: 78
Default

D Silicosis
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #3  
Old 07-27-2011
qurat21's Avatar
USMLE Forums Master
 
Steps History: 1 + CK
Posts: 623
Threads: 62
Thanked 287 Times in 186 Posts
Reputation: 297
Default

may b C or D
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #4  
Old 07-27-2011
USMLE Forums Scout
 
Steps History: Not yet
Posts: 10
Threads: 0
Thanked 7 Times in 5 Posts
Reputation: 17
Default

D. Silicosis

Silica can disrupt and impair macrophages. And usually found in upper lobes.
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #5  
Old 07-27-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,259 Times in 881 Posts
Reputation: 3269
Default

So, the key here is the present of foamy macrophages = lipoid pneumonia...I had a similar question in kaplan qbook....and this is a post-obstructive pneumonia...so, i'm between C) and E)...

btw, in Silicosis you have multiple small rounded opacities 1-10 mm in size...
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #6  
Old 07-27-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,259 Times in 881 Posts
Reputation: 3269
Search

lipid (lipoid) pneumonia

Golden Yellow Consolidation at autopsy of Lung-lipoidn2.jpg
click image to enlarge
Reply With Quote Quick reply to this message
The above post was thanked by:
dr.digant (07-28-2011), rulz (07-27-2011), star123 (07-28-2011), struggle (07-28-2011), usmle2011 (07-27-2011)
  #7  
Old 07-27-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,175
Threads: 38
Thanked 852 Times in 478 Posts
Reputation: 862
Default

Quote:
Originally Posted by bebix View Post
So, the key here is the present of foamy macrophages = lipoid pneumonia...I had a similar question in kaplan qbook....and this is a post-obstructive pneumonia...so, i'm between C) and E)...

btw, in Silicosis you have multiple small rounded opacities 1-10 mm in size...
Im stuck with those too.

But I think goljan said Peripheral Ca of Lungs are usually Adenoca's, so lets go with C)
__________________
PGY-3
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #8  
Old 07-27-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 566
Threads: 25
Thanked 522 Times in 263 Posts
Reputation: 532
Default

I'll go with Answer is E
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #9  
Old 07-27-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 566
Threads: 25
Thanked 522 Times in 263 Posts
Reputation: 532
Default

Quote:
Originally Posted by bebix View Post
So, the key here is the present of foamy macrophages = lipoid pneumonia...I had a similar question in kaplan qbook....and this is a post-obstructive pneumonia...so, i'm between C) and E)...

btw, in Silicosis you have multiple small rounded opacities 1-10 mm in size...
I was thinking on silicosis, those were my 2 choices... Pretty tempting to choose Silica... Because it disrupt the Phagolysosome and macrophage
Reply With Quote Quick reply to this message
The above post was thanked by:
bebix (07-27-2011), usmle2011 (07-27-2011)
  #10  
Old 07-27-2011
jahn77's Avatar
USMLE Forums Guru
 
Steps History: Step 1 Only
Posts: 326
Threads: 20
Thanked 220 Times in 124 Posts
Reputation: 232
Default

Pic of foamy macrophages, from library med utah...
http://library.med.utah.edu/WebPath/...L/LUNG125.html

My choice is C) squamous cell Ca, as it may obstruct bronchi and and be cause of lung destruction
Second E) adenoCa...just for the case...
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #11  
Old 07-27-2011
USMLE Forums Addict
 
Steps History: Not yet
Posts: 140
Threads: 5
Thanked 117 Times in 66 Posts
Reputation: 127
Default

well for me foamy macrophages takes me to the fat filled macrophages in the pathogenesis of atherosclerosis. But Is the answer adenocarcinoma?
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (07-27-2011)
  #12  
Old 07-27-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 512
Threads: 57
Thanked 318 Times in 163 Posts
Reputation: 328
Default Explanation

SOURCE : Webpath

(A) Incorrect. Mycoplasma infection produces an atypical pneumonia with interstitial infiltrates. Obstruction of airways is unlikely.

(B) Incorrect. The obstruction with inflammation of cystic fibrosis leads to bronchiectasis.

C) Incorrect. Most adenocarcinomas are peripheral and do not arise within a large bronchus.

(D) Incorrect. The silicotic nodules are small (a few millimeters) and do not obstruct bronchi.

(E) CORRECT. Most squamous cell carcinomas are located centrally and arise in bronchi, leading to obstruction of a large airway that can cause a lipid pneumonia. In this case, the breakdown of lung tissue distal to the mass yields an 'endogenous lipid pneumonia.'

(F) Incorrect. Mesotheliomas arise in the pleura and are peripheral masses unlikely to obstruct proximal bronchi to produce a lipid pneumonia.

(G) Incorrect. Thromboemboli obstruct the pulmonary arterial system, not the bronchi
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulaziz (10-15-2011), bebix (07-28-2011), docchitra (12-21-2011), dr_lizard (07-27-2011), dr.digant (07-28-2011), mkamal23 (07-28-2011), qurat21 (07-28-2011), rulz (07-28-2011), star123 (07-28-2011), struggle (07-28-2011), voicesinmyhead (08-04-2013)
  #13  
Old 07-27-2011
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 288
Threads: 28
Thanked 90 Times in 73 Posts
Reputation: 100
Default

[QUOTE=jahn77;56613]Pic of foamy macrophages, from library med utah...
http://library.med.utah.edu/WebPath/...L/LUNG125.html

My choice is C) squamous cell Ca, as it may obstruct bronchi and and be cause of lung destruction
Second E) adenoCa...just for the case...[/QUO

adding this link to this Q discussion was useful cheers
Reply With Quote Quick reply to this message
  #14  
Old 07-28-2011
USMLE Forums Addict
 
Steps History: Not yet
Posts: 151
Threads: 39
Thanked 52 Times in 29 Posts
Reputation: 62
Star D

D Silicosis
Reply With Quote Quick reply to this message
  #15  
Old 07-28-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 566
Threads: 25
Thanked 522 Times in 263 Posts
Reputation: 532
Default

Its WebPath a good course ? How do you find it ? Thanks.
Reply With Quote Quick reply to this message



  #16  
Old 07-28-2011
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 288
Threads: 28
Thanked 90 Times in 73 Posts
Reputation: 100
Default

Quote:
Originally Posted by rulz View Post
Its WebPath a good course ? How do you find it ? Thanks.
actually its one of the FA recommended internet site
Reply With Quote Quick reply to this message
  #17  
Old 10-12-2011
USMLE Forums Addict
 
Steps History: CK Only
Posts: 178
Threads: 61
Thanked 250 Times in 105 Posts
Reputation: 260
Correct Answer Squamous Cell Carcinoma

In lung cancer, especially in squamous cell carcinoma of the lung, airways are frequently obstructed by tumor invasion. Radiographically, this condition was recognized as atelectasis and opacification of lung parenchyma distal to an obstructed airway (1,2).
In 1949, McDonald et al. (3) first described the latter finding as ‘obstructive pneumonitis’, which is characterized by the presence of bronchial obstruction and the accumulation of lipid-filled macrophages. Although it had previously been believed that the obstructive pneumonitis was caused by infection mainly in the obstructed bronchus (3,4), in fact the condition is due to a non-infectious process, such as physical or chemical effects of airway blockage (1,2,5). Thus, we now understand that obstructive pneumonitis (obstructive pneumonia) on radiographs is synonymous with golden pneumonia in gross pathology and with endogenous lipoid pneumonia, which is characterized by numerous foamy macrophages in the air spaces with some degree of interstitial mononuclear infiltration (6).
In spite of the terminology ‘obstructive’, the obstructive effect sometimes accounts for a much larger infiltrate on the usual chest radiograph than is caused by the tumor alone (6,7), but there have been few radiolopathological studies of this condition.


Ref: http://jjco.oxfordjournals.org/content/28/8/492.full
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulaziz (10-15-2011)



Reply

Tags
Figures-, Pathology-, Respiratory-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Hemoptysis, Anemia, Consolidation, and Hematuria! aghammoud85 USMLE Step 2 CK Forum 8 07-21-2013 05:57 AM
autopsy ricko335 USMLE Step 1 Forum 3 08-16-2011 07:28 AM
Why Lemon Yellow Color in Pernicious Anemia! chienpolska USMLE Step 1 Forum 1 08-10-2011 02:01 AM
Yellow Brown discoloration after sun exposure! Ace3 USMLE Step 2 CK Forum 4 07-08-2011 07:50 PM
Liver autopsy Mahir USMLE Step 1 Forum 4 12-29-2009 10:18 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)