Difference between revisions of "IPLab:Lab 5:α1 Antitrypsin Deficiency"

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(Autopsy Findings)
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File:IPLab5Antitrypsin2.jpg|This is a gross photograph of the cut sections of lung from this case. The lung parenchyma is markedly hemorrhagic and consolidated. Again the hemorrhage makes it difficult to appreciate the emphysematous changes.  
 
File:IPLab5Antitrypsin2.jpg|This is a gross photograph of the cut sections of lung from this case. The lung parenchyma is markedly hemorrhagic and consolidated. Again the hemorrhage makes it difficult to appreciate the emphysematous changes.  
 
File:IPLab5Antitrypsin3.jpg|This is a gross photograph of the bronchi and lungs. Note the hemorrhage in the bronchi and in the lung parenchyma.  
 
File:IPLab5Antitrypsin3.jpg|This is a gross photograph of the bronchi and lungs. Note the hemorrhage in the bronchi and in the lung parenchyma.  
File:IPLab5Antitrypsin4.jpg|This low-power photomicrograph demonstrates the hemorrhage present throughout the lung. Note also the large air spaces; even though they are filled with blood, the emphysematous enlargement of the spaces is appreciable.   
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File:IPLab5Antitrypsin4b.jpg|This low-power photomicrograph demonstrates the hemorrhage present throughout the lung. Note also the large air spaces; even though they are filled with blood, the emphysematous enlargement of the spaces is appreciable.   
File:IPLab5Antitrypsin5.jpg|This is a low-power photomicrograph from an area of the lung without significant hemorrhage. The enlarged, emphysematous air spaces are easily appreciated.   
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File:IPLab5Antitrypsin5b.jpg|This is a low-power photomicrograph from an area of the lung without significant hemorrhage. The enlarged, emphysematous air spaces are easily appreciated.   
 
File:IPLab5Antitrypsin6.jpg|This is a gross photograph of the liver from this case. The capsule is somewhat thickened and the surface is slightly roughened, though it is difficult to appreciate the nodularity of the liver.  
 
File:IPLab5Antitrypsin6.jpg|This is a gross photograph of the liver from this case. The capsule is somewhat thickened and the surface is slightly roughened, though it is difficult to appreciate the nodularity of the liver.  
 
File:IPLab5Antitrypsin7.jpg|This is a gross photograph of the cut section of liver from this case. In this view the liver looks smaller than normal and there is a definite micronodular appearance.  
 
File:IPLab5Antitrypsin7.jpg|This is a gross photograph of the cut section of liver from this case. In this view the liver looks smaller than normal and there is a definite micronodular appearance.  

Revision as of 19:44, 8 July 2020

Clinical Summary[edit]

This 68-year-old white female was afflicted with severe emphysema due to alpha 1-antitrypsin deficiency. She had a 10 pack-year history of cigarette smoking but she had quit smoking 30 years ago. She elected to undergo lung volume reduction surgery to reduce complications of her emphysema. Post-operatively, she was ventilator dependent and her liver function declined. Further studies revealed hepatic cirrhosis. Her pulmonary function continued to decline and she died 26 days after her surgery.

At autopsy there were severe emphysematous changes in all lung lobes and there was massive hemorrhage throughout the lungs. The liver weighed 860 grams and there was micronodular cirrhosis.

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Study Questions[edit]


Additional Resources[edit]

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Journal Articles[edit]

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Related IPLab Cases[edit]

Pulmonary emphysema is a condition in which the air spaces distal to the terminal bronchioles are permanently increased in size due to either destruction of the wall or alveolar dilatation.

A pack-year denotes smoking one pack of cigarettes per day for one year.

Cirrhosis is a liver disease characterized by necrosis, fibrosis, loss of normal liver architecture, and hyperplastic nodules.

A normal partial thromboplastin time is 28 to 37 seconds.

Friable material is easily crumbled.

Consolidation is the filling of lung air spaces with exudate--this is a sign of pneumonia.