Image a shows a normal bronchiole. Smoking excites the Langerhans cell which in turn induces attracts early cellular interstitial infiltrates of surrounding the bronchiole (b) including lymphocytes, macrophages, eosinophils, plasma cells, and fibroblasts. The cellular infiltrate progresses in a peribronchial pattern with mass effect on the bronchiole which becomes narrowed (c) and eventually disappears, a nodules of varying size manifest in the bronchiole pathway, sometimes round but often spiculated as the inflammatory reaction extends into the interstitium (d) The wall of the bronchiole breaks down and the cellular infiltrate may undergo necrosis resulting in thick walled cavities, sometimes round in shape (e) and sometimes with bizarre shapes (f) Eventually the inflammation recedes and a thin walled cyst remains (g ,h) Ashley Davidoff MD TheCommonVein.netThe wall of the bronchiole breaks down and the cellular infiltrate may undergo necrosis resulting in thick -walled cavities, sometimes round in shape. Ashley Davidoff MD TheCommonVein.net lungs-0725As the inflammatory response subsides, thin-walled cavities evolve. Ashley Davidoff MD TheCommonVein.net lungs-0728b -hi resThe wall of the bronchiole breaks down and the cellular infiltrate may undergo necrosis resulting in thick -walled cavities, sometimes bizarre in shape. Ashley Davidoff MD TheCommonVein.net lungs-0726As the inflammatory response subsides, thin-walled cavities evolve, sometimes bizarre in shape. Ashley Davidoff MD TheCommonVein.net lungs-0728b
