ferruginous bodies vs. hemosiderin

[skk3]

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Hi, first post ever! haha..

I was hoping someone could clarify something for me. I had a UW question where an examination of an old man's lung revealed "alveolar cells containing golden cytoplasmic granules that turn dark blue with Prussian blue staining." I was thinking asbestos or hemosiderin. The answer choices I was unsure about were: "left ventricular dysfunction" or "interstitial lung fibrosis"

How was I supposed to deduce that hemosidern would be the better answer? Is it because the substance was golden "granules" rather than say... golden "bodies"? Or is it simply that heart failure is much more common than asbestos?

Also, do ferruginous bodies turn blue upon Prussian blue staining? I assumed it did because the fibers are coated with iron and protein, but I just wanted to make sure.

Any information would be appreciated! Thanks

 

[RapplixGmed]

There is no way to tell the difference between them using the color of stains. The stuff that is layered on top of the asbestos in ferringuinous bodies IS hemosiderin. Its the exact same stuff that is in alveolar macrophages that are "heart failure cells".

The key is the shape (the linear shape is the key feature if ferringinous bodies and it would take a really cruel test writer to not mention the most important feature of a histo slide when describing it) and the fact that ferringuinous bodies are in the interstitium and not in the alveoli.

 

[Ibrahim110]

I may be wrong, but I would say the only way to differentiate between ferruginous bodies and heart failure cells in this question would be that the ferruginous bodies would be in the alveolar septum (interstitial) and not inside the alveolar lumen as this question suggests, possibly making the question still valid, if this is the case. So, please correct me if i'm wrong, but in a nutshell:

Ferruginous bodies - alveolar SEPTUM (interstitial)

Heart failure cells - alveolar LUMEN (and as granules)

I struggled with the same question and could not think of any other way to decide between the two than to come up with this deduction.

 

[Dixe Reb]

SAME:
Ferruginous bodies and hemosiderin are both...
1. golden brown
2. found in macrophages
3. stain with Prussian blue
4. found in lungs
DIFFERENT:
FERRUGINOUS BODIES indicate asbestos --> asbestosis (interstitial, not alveolar) --> mesothelioma(cancer of pleural lining, not of the alveoli)
HEMOSIDERIN indicates pulmonary congestion, the sequelae of L ventricle failure; hence their moniker, "heart failure cells"
Therefore, since many features are the same, you will have to get your clues from the context of the patient presentation. In my case a smoker with dyspnea, cough, and HTN should have made it obvious he had heart failure, not asbestos. I was thrown by the fact he was an immigrant; I thought maybe no laws against asbestos construction in his home country? Oh well, live and learn.