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Common Pathways and Patterns of Injury

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Pulmonary Pathology

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Abstract

Pulmonary diseases often affect the lung parenchyma in a relatively specific and predictable distribution. In addition, a striking or predominant histopathologic feature (e.g., nonnecrotizing granulomas in sarcoidosis) frequently provides an important clue to the diagnosis. Recognition of the resulting patterns of lung injury at low magnification can be extremely useful in limiting diagnostic considerations. Thus, two important questions to address in histologically categorizing lung lesions are (1) which compartments are primarily affected (i.e., what is the distribution of the changes?), and (2) what is the nature of the predominant tissue reaction (e.g., acute/chronic inflammatory infiltrate, proliferation of fibroblasts, collagen deposition, granulomatous inflammation, lung necrosis, neoplastic proliferation, etc.)? This scheme of “pattern recognition” can greatly facilitate histopathologic analysis of a surprisingly large number of lung diseases. This chapter provides a general summary of anatomic features important in biopsy and autopsy diagnosis of a wide range of pulmonary conditions, reviews some of the shortcomings in using pattern recognition as a diagnostic approach, and emphasizes examples of classical patterns of acute and chronic lung injury. For more detailed discussions concerning clinical and pathologic features of the specific diseases illustrated in this section, the reader is referred to corresponding chapters elsewhere in this volume.

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Authors
  1. Jeffrey L. Myers
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  2. Thomas V. Colby
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  3. Samuel A. Yousem
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Editors and Affiliations

  1. Department of Pathology, The Virginia Mason Clinic, 98101, Seattle, WA, USA

    David H. Dail MD

  2. Diagnostic Specialties Laboratory, 700 Lebo Boulevard, 98310, Bremerton, WA, USA

    Samuel P. Hammar MD

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Myers, J.L., Colby, T.V., Yousem, S.A. (1994). Common Pathways and Patterns of Injury. In: Dail, D.H., Hammar, S.P. (eds) Pulmonary Pathology. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3935-0_4

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  • DOI: https://doi.org/10.1007/978-1-4757-3935-0_4

  • Publisher Name: Springer, New York, NY

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