Pathology wk 29-32: SLE, lung carcinoma

Systemic Lupus Erythematosus (SLE or lupus) is a chronic autoimmune disease that can be fatal, though with recent medical advances fatalities are becoming increasingly rare. As with other autoimmune diseases, the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. SLE can affect any part of the body, but most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remission. Lupus can occur at any age, and is most common in women, particularly of non-European descent.^[1] Lupus is treatable symptomatically, mainly with corticosteroids and immunosuppressants, though there is currently no cure. However, many people with Lupus lead long and substantial lives.

90% female and between ages 14 and 15
symptoms
fever, fatigue, weight loss, non-bacterial verrucous endocarditis, hilar adenopathy, and Raynaud's phenomenon - vasospastic disorder accompanying discoloration of fingers, toes
false positives on VDRL/RPR
lab tests detect presence of
1. antinuclear antibodies(ANA) - sensitive, not specific
2. Antibodies to double-stranded DNA(anti-dsDNA) - specific, poor prognosis
3. Anti-Smith antibodies (anti-Sm) - specific but not prognostic
4. Antihistone antibodies - drug induced lupus

malar rash

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Lung Cancer

Squamous cell carcinoma
Adenocarcinoma

small-cell(oat-cell) carcinoma
Undifferentiated -> very aggressive; often associated with ectopic production of ACTH or ADH; may lead to Lambert-Eaton syndrome(autoimmune disorder affecting neuromuscular junction)
Neoplasm of neuroendocrine - Kulchitsky cells -> small dark blue cells



Large cell carcinoma
Highly anaplastic undifferentiated tumor with poor prognosis
Pleomorphic giant cells with leukocyte fragments in cytoplasm


Carcinoid tumor
Metastases


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