| • This is the lung distal to an obstructing intrabronchial neoplasm.
• The arrows point to bronchi distended by inspissated mucus extending out to the pleural surface.
• Although it is not visible, the surrounding lung was not aerated by palpation. |
| Bronchopneumonia |
| Etiology |
• Variety of aspirated organisms. • Organism dependent on whether community acquired in previously healthy
patient (more likely Streptococcus) or • Community acquired in patient with depressed pulmonary defenses such as a
patient with chronic bronchitis (more likely Klebsiella or Pseudomonas spps)
or • Hospital acquired |
| Pathogenesis |
• Aspiration of organisms results in inflammation and necrosis of
underlying parenchyma • Tends to scar if alveolar septae are destroyed |
| Epidemiology |
• Common in hospitalized patients and
contributes to the cause of death in moribund patients • Most common community acquired pneumonia as well |
| Clinical |
• Clinical course dependent on underlying disease processes • Patients present with fever, cough and purulent sputum |
| General Gross Description |
• Patchy distribution particularly around small airways • Nodular, elevated, firm, airless regions • Range from red to gray depending on age of the lesion • Can become confluent to mimic lobar pneumonia |
| General Micro Description |
• Bronchocentric lesions • Neutrophils fill airway and surrounding alveoli • Parenchymal destruction depends on organism • Uninvolved parenchyma may contain acellular pink edema |
| Reference |
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 694-698.
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