{"id":11251,"date":"2026-08-30T20:00:00","date_gmt":"2026-08-30T18:00:00","guid":{"rendered":"https:\/\/konspat.pl\/?p=11251"},"modified":"2026-09-07T19:55:14","modified_gmt":"2026-09-07T17:55:14","slug":"przypadek-379","status":"publish","type":"post","link":"https:\/\/konspat.pl\/index.php\/2026\/08\/30\/przypadek-379\/","title":{"rendered":"Przypadek 379."},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Pacjent 78 letni, wieloletni palacz tytoniu, w trakcie diagnostyki przewlek\u0142ego kaszlu wykonano bronchofiberoskopi\u0119. W jednym z oskrzeli segmentowych p\u0142uca lewego stwierdzono pogrubienie jego b\u0142ony \u015bluzowej z nieregularno\u015bci\u0105 i wzrostem ilo\u015bci naczy\u0144 krwiono\u015bnych wymiar\u00f3w oko\u0142o 1,5&#215;1,2cm. Ze zmiany pobrano wycinki do badania. W badaniach obrazowych wykluczono obecno\u015b\u0107 guza.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Do badania makroskopowego nades\u0142ano 5 wycink\u00f3w tkankowych wymiar\u00f3w od 0,1 do 0,4cm.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Obrazy mikroskopowe:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214100-1024x768.jpg\" alt=\"\" class=\"wp-image-11242\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214100-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214100-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214100-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214100-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214100-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214114-1024x768.jpg\" alt=\"\" class=\"wp-image-11243\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214114-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214114-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214114-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214114-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214114-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214127-1024x768.jpg\" alt=\"\" class=\"wp-image-11244\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214127-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214127-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214127-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214127-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214127-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214138-1024x768.jpg\" alt=\"\" class=\"wp-image-11245\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214138-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214138-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214138-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214138-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214138-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214207-1024x768.jpg\" alt=\"\" class=\"wp-image-11246\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214207-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214207-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214207-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214207-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214207-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214539-1024x768.jpg\" alt=\"\" class=\"wp-image-11247\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214539-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214539-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214539-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214539-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20240926_214539-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Cechy charakterystyczne:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>b\u0142ona \u015bluzowa oskrzela pokryta jest pogrubia\u0142ym nab\u0142onkiem wielowarstwowym p\u0142askim<\/li>\n\n\n\n<li>kom\u00f3rki nab\u0142onka p\u0142askiego powi\u0119kszone, w cz\u0119\u015bci r\u00f3\u017cnej wielko\u015bci i kszta\u0142tu (niebieska strza\u0142ka), wzrost stosunku j\u0105drowo \u2013 cytoplazmatycznego, chromatyna ziarnista i nier\u00f3wna, j\u0105dra kom\u00f3rkowe zakrzywione, modeluj\u0105ce si\u0119, obecno\u015b\u0107 j\u0105derek, w dolnych dw\u00f3ch trzecich j\u0105dra kom\u00f3rkowe u\u0142o\u017cone prostopadle, figury podzia\u0142u w dolnych dw\u00f3ch trzecich wysoko\u015bci nab\u0142onka (\u017c\u00f3\u0142ta strza\u0142ka)<\/li>\n\n\n\n<li>niewielkie dojrzewanie od podstawy do powierzchni nab\u0142onka \u2013 kom\u00f3rki powierzchowne sp\u0142aszczone (czerwona strza\u0142ka), kom\u00f3rki warstwy podstawnej z ich st\u0142oczeniem obecne w g\u00f3rnych dw\u00f3ch trzecich wysoko\u015bci nab\u0142onka, warstwa po\u015brednio s\u0142abo zaznaczona<\/li>\n\n\n\n<li>brak przekraczania b\u0142ony podstawnej (przerywana linia), brak rozrostu warstwy podstawnej na ca\u0142ej wysoko\u015bci nab\u0142onka p\u0142askiego, brak mitoz na ca\u0142ej wysoko\u015bci nab\u0142onka, brak utraty r\u00f3wnoleg\u0142o\u015bci do b\u0142ony podstawnej dolnych 2\/3 nab\u0142onka<\/li>\n\n\n\n<li>wykonane badania dodatkowe: p40(+), CK5\/6(+), Ki67(+ w 2\/3 wysoko\u015bci nab\u0142onka), p53(+)<\/li>\n\n\n\n<li>w badaniach obrazowych brak cech inwazyjnego guza<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/scc-in-situ-pluco-1024x768.jpg\" alt=\"\" class=\"wp-image-11240\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/scc-in-situ-pluco-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/scc-in-situ-pluco-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/scc-in-situ-pluco-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/scc-in-situ-pluco-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/scc-in-situ-pluco-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/CK56-1024x768.jpg\" alt=\"\" class=\"wp-image-11241\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/CK56-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/CK56-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/CK56-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/CK56-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/CK56-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">CK5\/6<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p40-1024x768.jpg\" alt=\"\" class=\"wp-image-11249\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p40-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p40-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p40-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p40-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p40-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">p40<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p53-1024x768.jpg\" alt=\"\" class=\"wp-image-11250\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p53-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p53-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p53-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p53-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/p53-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">p53<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/Ki67-1024x768.jpg\" alt=\"\" class=\"wp-image-11248\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/Ki67-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/Ki67-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/Ki67-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/Ki67-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/Ki67-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Ki67<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Rozpoznanie:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dysplazja nab\u0142onka p\u0142askiego p\u0142uc du\u017cego stopnia (Severe squamous dysplasia of the lung).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dodatkowe zdj\u0119cia i informacje:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/lungsquamouscellcarcinomainsitu.html\">https:\/\/www.pathologyoutlines.com\/topic\/lungsquamouscellcarcinomainsitu.html<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/oncohemakey.com\/bronchial-squamous-dysplasia-and-carcinoma-in-situ\/\">https:\/\/oncohemakey.com\/bronchial-squamous-dysplasia-and-carcinoma-in-situ\/<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Pacjent 78 letni, wieloletni palacz tytoniu, w trakcie diagnostyki przewlek\u0142ego kaszlu wykonano bronchofiberoskopi\u0119. W jednym z oskrzeli segmentowych p\u0142uca lewego<\/p>\n","protected":false},"author":46,"featured_media":11243,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"categories":[16,23],"tags":[],"class_list":["post-11251","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademia-patologa","category-przypadki"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts\/11251","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/users\/46"}],"replies":[{"embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/comments?post=11251"}],"version-history":[{"count":2,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts\/11251\/revisions"}],"predecessor-version":[{"id":11290,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts\/11251\/revisions\/11290"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/media\/11243"}],"wp:attachment":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/media?parent=11251"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/categories?post=11251"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/tags?post=11251"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}