Autopsy Findings

Serosanguineous pleural fluid was present (R 600 ml, L 800 ml). The cut surfaces of the lungs, which weighed 940 g on the right and 770 g on the left, had patchy areas of pallor and slight firmness--the interstitial pneumonia--and darker areas of hyperemia. The pale pneumonic areas tended to be peripheral and lobular, sometimes accentuating interlobular septa or bronchovascular bundles.

Because of the edema in this lung, the interlobular septa are more prominent than usual. Note the lobular distribution of the interstitial pneumonia at the arrow. Find other examples of a sharp demarcation between pale and darker red areas.

 

 

In the two CTs below, note irregular band-like and linear densities in the distribution of interlobular septa: posterior lung, image A (three are labeled with arrows, find others), and left anterior, peripheral lung, image B (arrow). See below for a description of the three posterior arrows.

AB

 

At higher magnification, the air spaces throughout the lung are slightly enlarged. These spaces represent alveolar ducts, which are dilated because the surrounding alveoli are collapsed. (See histology.)

In the CT above (image B), the peripheral band and line densities seen posteriorly in a subpleural distribution correlate well with the band-like regions of pallor (arrows) in the specimen.

Clinical summary Image 3

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