Pathophysiology of acute fibrinous and organizing pneumonia – Clinical and morphological spectra Cláudia Santos, Rui Caetano Oliveira, Paula Serra, João.

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Presentation transcript:

Pathophysiology of acute fibrinous and organizing pneumonia – Clinical and morphological spectra Cláudia Santos, Rui Caetano Oliveira, Paula Serra, João Pedro Baptista, Eduardo Sousa, Paula Casanova, Jorge Pimentel, Lina Carvalho Pathophysiology DOI: 10.1016/j.pathophys.2019.04.001 Copyright © 2019 Elsevier B.V. Terms and Conditions

Fig. 1 High-resolution chest CT presented diffuse ground glass opacities, intra-lobular reticulation and small cysts in the upper lobes, middle lobe and lingula, suggesting pulmonary fibrosis. Pathophysiology DOI: (10.1016/j.pathophys.2019.04.001) Copyright © 2019 Elsevier B.V. Terms and Conditions

Fig. 2 A – D: Patient 1. A – HE X 100; alveoli full of fibrin and peripheral fibroblasts. B – CK7 × 100; alveoli distortion by foci of young fibroblasts proliferation intermingled with fibrin matrix. C – CD68 × 100; macrophages surrounding fibrin balls. D – Vimentin X 200; inflammatory intra-alveolar myofibroblastic polyp. E – H: Patient 2. E – HE X 100; intra-alveolar hyaline membrane balls. F – CK7 × 200; hyaline membranes and inflammatory cells occupying alveolar spaces together with pneumocytes II hyperplasia. G – CD68 × 100; scarce number of macrophages surrounding hyaline balls. H – Vimentin X 100; reduced number of fibroblasts around a hyaline ball. I – L: Patient 3. I – HE X 100; fibroblasts proliferation and collagen deposition intermingled with fibrin membranes in alveolar spaces. J – CK7 × 100; homogeneous alveolar occupation by both fibroblasts and fibrin. K – CD68 × 100; macrophages clusters in alveolar spaces. L – Vimentin X 100; fibroblasts around a remnant of a fibrin ball. Pathophysiology DOI: (10.1016/j.pathophys.2019.04.001) Copyright © 2019 Elsevier B.V. Terms and Conditions

Fig. 3 Chest X-ray. Heterogeneous consolidation in right pulmonary field. Pathophysiology DOI: (10.1016/j.pathophys.2019.04.001) Copyright © 2019 Elsevier B.V. Terms and Conditions

Fig. 4 Chest CT. Bilateral consolidation areas and scattered centimetric bullae. Densification ground glass areas in the right upper lobe, traction bronchiectasis, interlobular septa thickening and subpleural cystic lesions. Pathophysiology DOI: (10.1016/j.pathophys.2019.04.001) Copyright © 2019 Elsevier B.V. Terms and Conditions