scholarly journals Diffuse Alveolar Damage of the Lungs in Forensic Autopsies: Assessment of Histopathological Stages and Causes of Death

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Halide Nur Urer ◽  
Gokhan Ersoy ◽  
Emine Dilek Yılmazbayhan
Keyword(s):  
Interstitial Pneumonia ◽  
Histopathological Examination ◽  
Diffuse Alveolar Damage ◽  
Lung Damage ◽  
European Respiratory Society ◽  
Acute Interstitial Pneumonia ◽  
Morphological Criteria ◽  
Hematoxylin And Eosin ◽  
Independent Variable ◽  
Lung Biopsies

Introduction. Diffuse alveolar damage (DAD) is a morphological prototype of acute interstitial pneumonia. Hospital autopsies or open-lung biopsies are used to monitor common alveolar damage and hyaline membrane (HM) development histopathologically. The aim of this study was to detect histopathological profiles and frequency of DAD and HM in adult forensic autopsies.Materials and Methods. In total, 6813 reports with histopathological samples in 12,504 cases on which an autopsy was performed between 2006 and 2008 were investigated. Sixty-six individuals >18 years of age who were diagnosed with DAD were included. Hematoxylin- and eosin-stained lung preparations were reexamined in line with the 2002 American Thoracic Society/European Respiratory Society idiopathic interstitial pneumonia consensus criteria.Results. Histopathological examination revealed that 50 cases (75.7%) were in the exudative phase and 16 (24.2%) were in the proliferative phase. Only the rate of alveolar exudate/oedema in exudative phase cases (); those of alveolar histiocytic desquamation (), alveolar fibrosis (), chronic inflammation (), and alveolar fibrin () in proliferative cases were significantly higher. The presence of alveolar fibrin was the only independent variable in favour of proliferative cases ().Conclusion. The detection of all DAD morphological criteria with the same intensity is not always possible in each case. Forensic autopsies may provide a favourable means for expanding our knowledge about acute lung damage, DAD, and interstitial lung disease.

scholarly journals Гістологічні зміни в котів за хламідіозу

2017 ◽  
Vol 19 (78) ◽  
pp. 158-161
Author(s):  
V. Lisova ◽  
A. Savchenko
Keyword(s):  
Lymph Nodes ◽  
Interstitial Pneumonia ◽  
Chlamydial Infection ◽  
Histopathological Examination ◽  
Clinical Manifestations ◽  
Bronchial Epithelium ◽  
Histological Structure ◽  
Regional Lymph Nodes ◽  
Morphological Criteria ◽  
Hematoxylin And Eosin

The article presents the results of the study of histological changes in organs and tissues of cats for chlamydial infection. The histopathological examination of the postmortem cases of cats (n = 8) of different breeds between the ages of 3 to 6 years old, who lives with the laboratory methods have been diagnosed and identified the pathogen Chlamydia felis. According to historical data from sick animals were recorded various nature and degree of conjunctivitis and pronounced signs of a lesion of the respiratory tract (rhinitis, bronchitis, pneumonia). The made histological sections were stained with hematoxylin and eosin according to routine standard methods. The general histological structure and microstructural changes in histological preparations were studied under a light microscope. The histopathological examination were confirmed and specified the pathoanatomical diagnoses, established after autopsy of dead animals. It is shown that the most pronounced damage and characteristic changes all dead cats fixed contact in lung tissues and regional lymph nodes (mediastinal and bronchial), and in the spleen. The morphological criteria of chlamydial infection in the studied dead animals at the microscopic level were as follows:1) interstitial pneumonia; 2) pulmonary fibrosis; 3) fibrinous-purulent pleuropneumonia; 4) hyperplasia and serous lymphadenitis of the mediastinal and bronchial lymph nodes; 5) hyperplasia of lymphoid nodules of the spleen; 6) passive venous congestion of the liver and kidneys; 7) fatty and granular liver dystrophy. The results of our study, the pathomorphological diagnosis of chlamydial infection in most of the cats that died was based on changes characteristic of interstitial pneumonia followed pneumosclerosis or fibrinous-purulent pleuropneumonia, with deep affection of the bronchial epithelium. Consequently, the features of chlamydial infection are such that the clinical picture does not always correspond to the severity of morphological manifestations and complications of infection. Weak clinical manifestations can be combined with significant destructive, degenerative and necrotic changes in organs and tissues.

A Rare Case of Acute Interstitial Pneumonia Diagnosed at Autopsy

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S153-S154
Author(s):  
E Conner ◽  
D Troxclair ◽  
H Khokhar ◽  
W Beversdorf
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Diffuse Alveolar Damage ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
High Dose ◽  
Atypical Pneumonia ◽  
Acute Interstitial Pneumonia ◽  
Diagnostic Role ◽  
History Of

Abstract Introduction/Objective Acute interstitial pneumonia (AIP) is a rare disease clinically characterized by rapidly progressing respiratory failure in individuals with no history of respiratory illness or other inciting factors. While most often diagnosed in middle-aged adults, it may present in any age group. Initial presentation is described as influenza- like, and respiratory failure requiring ventilatory support often progresses within weeks to months. Prognosis is poor, with an estimated mortality rate approaching 80% without treatment. Methods We present the case of a 44-year-old male nonsmoker with no significant medical history, who presented in 2018 with 1.5 months of dyspnea and headache initially diagnosed as atypical pneumonia. Chest imaging revealed bilateral opacities; however, microbial workup revealed no evidence of infectious etiology. Autoimmune serology studies were likewise unrevealing. Despite aggressive supportive and medical management, he deteriorated to respiratory failure and succumbed. Results At autopsy, the lungs were symmetrically congested and edematous (combined weight 2,340 g) but free of evident consolidation or discrete lesions. Microscopic examination revealed diffuse alveolar damage with extensive hyaline membrane formation, interstitial edema, and fibroblastic proliferation. The vasculature was severely congested, and the alveoli contained hemorrhage and scattered macrophages. No fungal or mycobacterial elements were identified by staining. Based on the histologic features and clinical context, the diagnosis of AIP was made. Conclusion AIP is a rare, aggressive, and diagnostically challenging disease that includes a broad range of both clinical and histologic differentials. Timely recognition and intervention with aggressive respiratory support and high- dose glucocorticoids are the mainstays of clinical management. The diagnostic role of histology is significant, but hinges on early clinical consideration of AIP as disease progression may later preclude the biopsy procedure. We share this case to raise awareness of this rapidly progressive and diagnostically troubling interstitial lung disease while emphasizing the importance of clinicopathologic correlation.

scholarly journals Video-Assisted Thoracoscopic Lung Biopsy as a Possible Cause of Acute Interstitial Pneumonia in a Patient with Nonspecific Interstitial Pneumonia

2004 ◽  
Vol 11 (6) ◽  
pp. 437-440 ◽  
Author(s):  
D Jeffrey Moore ◽  
Colm P McParland ◽  
Martin J Bullock ◽  
Yannick Cartier ◽  
Paul Hernandez
Keyword(s):  
Case Report ◽  
Interstitial Pneumonia ◽  
Lung Biopsy ◽  
Diffuse Alveolar Damage ◽  
Usual Interstitial Pneumonia ◽  
High Resolution Computed Tomography ◽  
Present Case Report ◽  
Video Assisted ◽  
Acute Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia

The present case report describes a 44-year-old woman who presented with dyspnea due to diffuse interstitial lung disease. High-resolution computed tomography showed features of usual interstitial pneumonia, but the lung biopsy obtained by video-assisted thoracoscopy was consistent with a histological pattern of nonspecific interstitial pneumonia. Following the procedure, the patient developed progressive respiratory distress and died on postoperative day 13 with a clinical picture of acute interstitial pneumonia. The autopsy showed evidence of diffuse alveolar damage superimposed on the background pattern of nonspecific interstitial pneumonia. The present case report supports the notion that patients with a variety of subtypes of idiopathic interstitial pneumonias may be at risk of exacerbation of their underlying disease following thoracic procedures, including video-assisted thoracoscopic lung biopsy.

scholarly journals BLEOMYCIN-INDUCED REVERSIBLE ACUTE INTERSTITIAL PNEUMONIA

2017 ◽  
Vol 10 (5) ◽  
pp. 6 ◽  
Author(s):  
Balaji Ommurugan ◽  
Amita Priya ◽  
Navin Patil ◽  
Joseph Thomas
Keyword(s):  
Adverse Drug Reaction ◽  
Interstitial Pneumonia ◽  
Pulmonary Toxicity ◽  
Causality Assessment ◽  
Chemotherapeutic Agent ◽  
Diffuse Alveolar Damage ◽  
Germ Cell Tumors ◽  
Lymphoma Patient ◽  
Drug Induced ◽  
Acute Interstitial Pneumonia

As of now, about 380 medications are implicated in causing respiratory reactions and most common among that is drug-induced interstitial disease.Oral, parental as well inhalational drugs are known to cause drug-induced interstitial lung disease. Bleomycin is a chemotherapeutic agent used inthe treatment of lymphomas, germ cell tumors of the testes. Most common pulmonary toxicity is diffuse alveolar damage with nonspecific interstitialpneumonitis being next. We report a case of bleomycin-induced reversible acute interstitial pneumonia in a Hodgkin’s lymphoma patient with adriamycin, bleomycin, vinblastine, dacarbazine regimen. Causality assessment was done using Naranjo scale, and probable causal relationship was established. Adverse drug reaction was found to be moderately severe and not preventable as per Hartwig’s severity and Thornton’s preventability scaling respectively.Keywords: Naranjo scale, Lymphoma, Bleomycin, Pneumonia.

Lung Biopsy Findings in Severe Pulmonary Illness Associated With E-Cigarette Use (Vaping)

2019 ◽  
Author(s):  
Sanjay Mukhopadhyay ◽  
Mitra Mehrad ◽  
Pedro Dammert ◽  
Andrea V Arrossi ◽  
Rakesh Sarda ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Lung Biopsy ◽  
Diffuse Alveolar Damage ◽  
Lung Damage ◽  
Cigarette Use ◽  
Lipoid Pneumonia ◽  
Lung Biopsies ◽  
Severe Lung

Abstract Objectives The aim of this report is to describe the lung biopsy findings in vaping-associated pulmonary illness. Methods Lung biopsies from eight patients with vaping-associated pulmonary illness were reviewed. Results The biopsies were from eight men (aged 19-61 years) with respiratory symptoms following e-cigarette use (vaping). Workup for infection was negative in all cases, and there was no evidence for other etiologies. Imaging showed diffuse bilateral ground-glass opacities in all patients. Most recovered with corticosteroid therapy, while one died. Lung biopsies (seven transbronchial, one surgical) showed acute lung injury, including organizing pneumonia and/or diffuse alveolar damage. Common features were fibroblast plugs, hyaline membranes, fibrinous exudates, type 2 pneumocyte hyperplasia, and interstitial organization. Some cases featured a sparse interstitial chronic inflammatory infiltrate. Although macrophages were present within the airspaces in all cases, this feature was not prominent, and findings typical of exogenous lipoid pneumonia were absent. Conclusions The histopathology of acute pulmonary illness related to e-cigarette use (vaping) is characterized by acute lung injury patterns, supporting the contention that vaping can cause severe lung damage.

scholarly journals Preliminary evidence that hydrostatic edema may contribute to the formation of diffuse alveolar damage in a Holstein calf model

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 374
Author(s):  
Joseph M. Neary ◽  
Dee Church
Keyword(s):  
Diastolic Dysfunction ◽  
Interstitial Pneumonia ◽  
Diffuse Alveolar Damage ◽  
Interventricular Septum ◽  
Clinical Signs ◽  
Preliminary Evidence ◽  
Left Ventricular ◽  
Feedlot Cattle ◽  
Acute Interstitial Pneumonia ◽  
Pulmonary Arterial

Background: Two notable findings of clinically healthy feedlot cattle suggest they may have pulmonary hydrostatic edema during the finishing phase of production: increased pulmonary arterial wedge pressures and pulmonary venous hypertrophy. The goal of this study was to determine if increased pulmonary arterial wedge pressure (PAWP) in a Holstein calf could lead to diffuse alveolar damage consistent with the early, exudative phase of acute interstitial pneumonia of feedlot cattle. Methods: Six male Holstein dairy calves were given daily subcutaneous injections of the nonspecific ß-adrenergic agonist isoprenaline (10 mg/kg/d), to induce left ventricular diastolic dysfunction, or sterile water for 14 days. On Day 14, pulmonary arterial pressures and wedge pressures were measured, echocardiography performed, and the ratio of mitral valve flow velocity (E) to septal lengthening velocity (e’) calculated. Calves were euthanized on Day 15 and lung lesions semi-quantitatively scored. Results: Mean PAWP was 12 ± 1 mm Hg in calves that received isoprenaline and 7 ± 1 mm Hg in controls (P = 0.01). Calves that received isoprenaline tended to have greater relative wall thickness than control calves (P = 0.15) and greater E/e’ ratios (P = 0.16), suggestive of concentric hypertrophy and diastolic dysfunction, respectively. Calves that received isoprenaline also tended to have a left ventricle and interventricular septum that was 29 ± 10 g heavier than control calves (P = 0.10) when controlling for body mass. Hyaline membranes, the hallmark feature of diffuse alveolar damage, were evident in lung sections from all calves that received isoprenaline but none of the controls. Conclusions: Consistent with prior pathological and physiological studies of feedlot cattle, this study provides preliminary evidence that cattle presenting with clinical signs and pathology consistent with early stage acute interstitial pneumonia could be attributable to hydrostatic edema associated with left ventricular failure.

scholarly journals Idiopathic interstitial pneumonias: review of the latest American Thoracic Society/European Respiratory Society classification

2018 ◽  
Vol 51 (5) ◽  
pp. 321-327 ◽  
Author(s):  
Daniel Simões Oliveira ◽  
José de Arimatéia Araújo Filho ◽  
Antonio Fernando Lins Paiva ◽  
Eduardo Seigo Ikari ◽  
Rodrigo Caruso Chate ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
American Thoracic Society ◽  
European Respiratory Society ◽  
Cryptogenic Organizing Pneumonia ◽  
Pleuroparenchymal Fibroelastosis ◽  
Idiopathic Interstitial Pneumonias ◽  
Acute Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia ◽  
Original Classification

Abstract The diagnosis of idiopathic interstitial pneumonias (IIPs) involves a multidisciplinary scenario in which the radiologist assumes a key role. The latest (2013) update of the IIP classification by the American Thoracic Society/European Respiratory Society proposed some important changes to the original classification of 2002. The novelties include the addition of a new disease (idiopathic pleuroparenchymal fibroelastosis) and the subdivision of the IIPs into four main groups: chronic fibrosing IIPs (idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia); smoking-related IIPs (desquamative interstitial pneumonia and respiratory bronchiolitis-associated interstitial lung disease); acute or subacute IIPs (cryptogenic organizing pneumonia and acute interstitial pneumonia); rare IIPs (lymphoid interstitial pneumonia and idiopathic pleuroparenchymal fibroelastosis); and the so-called “unclassifiable” IIPs. In this study, we review the main clinical, tomographic, and pathological characteristics of each IIP.

Acute Interstitial Pneumonia Presenting as Diffuse Alveolar Damage With Positive Scl-70 Antibodies: Cart Before the Horse?

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 383A
Author(s):  
Mohammed Moizuddin ◽  
Muhammed Imtiaz ◽  
Mohammed Nayeem ◽  
Ria Gripaldo
Keyword(s):  
Interstitial Pneumonia ◽  
Diffuse Alveolar Damage ◽  
Acute Interstitial Pneumonia
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