Pulmonary Hemorrhage, Hemosiderosis, and Ferruginization of Elastic Tissue

Bleeding as a Result of Venous Obstruction

Narrowing of small pulmonary veins by the proliferating LAM cells may lead to alveolar hemorrhages as in veno-occlusive disease. Besides RBCs, hemosiderin-filled macrophages are also present in alveoli. When the process is chronic, iron can be deposited as black pigment on elastic fibers in the lung. Such deposition may be accompanied by a foreign-body giant cell reaction.



Find two clusters of hemosiderin-laden macrophages in alveoli.

Find iron-encrusted elastic lamina around a small vein.

Find a foreign-body giant cell.


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Hemosiderin-filled, alveolar macrophages





























Foreign-body giant cell adjacent to an iron-encrusted elastic fiber




























Iron-deposition (ferruginization) on elastic fibers