Histologic Changes in the Biopsy

A. The parenchyma has an inflammatory reaction.

1) Is the inflammation temporally all of the same age, or are there recent (granulation tissue) and old (scarred) components?

2) Where is the inflammation occurring--in alveolar spaces, or in the interstitium?

 

3) What type of tissue is present around the asterisks? Answers

B. This photo from another case shows an earlier stage of disease with prominent hyaline membranes (arrow) lining air spaces. Membranes were mostly resolving in the present case.

C. What types of cells are causing the widening of the alveolar walls?

Answer

 

Clinical summaryImage 2

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1) Is the inflammation temporally all of the same age, or are there recent (granulation tissue) and old (scarred) components? In all areas of the biopsy, the inflammatory changes were of the same age. There was no evidence of old scar, which would be darker pink.

2) Where is the inflammation occurring--in alveolar spaces, or in the interstitium? The inflammation is both in the alveolar spaces and in the interstitium. In this entity, the interstitial component usually predominates. The alveolar component gradually becomes epthelialized and incorporated into the interstitium.

3) What type of tissue is present around the asterisks? Granulation tissue, which is a mixture of spindled, myofibroblastic, connective tissue cells, capillaries, and chronic inflammatory cells.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What types of cells are causing the widening of the alveolar walls? Walls are widened by the granulation tissue and hyperplastic type II cells. The thickened alveolar walls and increased numbers of alveolar macrophages constitute an alveolitis, which is one component of interstitial pneumonia. Inflammation around airways and vessels is also present in interstitial pneumonia.

Clinical summaryImage 2

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