Virtual Slidebox
Presented by the MGH Pathology Service

New infiltrate in 60 yo asbestos-exposed construction worker

56 y/o male smoker with digital clubbing, no respiratory complaints, and a diffusely abnormal chest CT.

Female in her 60’s with a seven-year history of chronic, productive cough

37 y/o female with chronic lung disease

50 yo with ground glass densities

Male in his 60’s with bilateral nodular pulmonary infiltrates. Note branching tongues of fibrous tissue in airspaces and eosinophils.

Female in her 50’s with dyspnea and bilateral ground-glass opacities

54 y/o male with pulmonary nodules

60 yo F, non-smoker with diffuse pulmonary infiltrate

Male in his 50’s with recurrent respiratory failure, s/p prior admission to ICU one month ago. Note interstitial fibrosis, hyperplastic pneumocytes, focal fibrin and OP changes, and absence of hyaline membranes.

Read more on Diffuse alveolar damage, late organizing phase…

Female in her 60’s with fevers and admission for acute respiratory distress two weeks ago. Note hyaline membranes, proliferative interstitial and intra-alveolar fibrosis, and prominent pneumocytes.

Female in her 20’s with severe endometriosis and pulmonary infiltrates

Male in his 70’s with dyspnea. Note bronchiolocentric granulomas with giant cells, small tufts of OP, peribronchial metaplasia, interstitial fibrosis

Pregnant female in her 40’s with spontaneous pneumothorax

Clinical summary
45 yo F. Lung explant. Removed for presumed rejection. Prior lung transplant 8 yrs ago.

Female in her 40’s with bilateral infiltrates and dyspnea

Male in his 40’s with respiratory failure

Clinical history:

51 y/o male with diffuse pulmonary opacities and dyspnea.

Pathogenesis:

Possible etiologies for small-vessel vasculitis in the lungs include ANCA disease (Wegener’s granulomatosis, microscopic polyangiitis), collagen vascular disease (lupus, others), and anti-GBM disease.

Read more on Pulmonary capillaritis (vasculitis), subacute…

Autopsy: heavy lungs and cardiac hypertrophy

49 yo female with diffuse bilateral ground glass opacities

Clinical summary
49 yo female with diffuse bilateral ground glass opacities

Male smoker in his 50’s with patchy pulmonary infiltrates. Note patchy distribution, with scant inflammation around terminal airways, peribronchiolar metaplasia, filling of terminal airways with macrophages, and interstitial fibrosis.

Male in his 30’s with nodular pulmonary opacities

Female in her 60’s with progressive dyspnea

Female in her 60’s with dyspnea

Male in his 20’s with fever, dyspnea, and rash. Note bronchiolar and alveolar mixed inflammation and scattered highly atypical pneumocytes