Ashley Davidoff MD TheCommonvein.net lungs-0775-b (Reference De Giacomi F et al)
Ashley Davidoff MD TheCommonvein.net lungs-0775-bL (Reference De Giacomi F et al)
As the disease advances the small airways, and alveoli, get progressively filled with eosinophils, inflammatory cells and fluids resulting in consolidation. This image reveals progressive filling of the small airways, (a) alveoli, (b) and secondary lobules (c) with eosinophils and products of inflammation resulting in multi-segmental consolidations (d), in the lung bases, with air bronchograms at the right base (e), and less dense consolidation at the left base (f)
Ashley Davidoff MD The CommonVein.net lungs-0763
This diagram reveals the important structural changes in the secondary lobule that includes filling of the alveoli with eosinophils and proteinaceous and fibrinous exudate as well as infiltration into the alveoar septa and interstitium (redwalls) . An important component of the disease is the thickening of the interlobular septa (maroon) which results in Kerley B lines and an interstitial pattern reminiscent of cardiogenic interstitial edema.
Ashley Davidoff TheCommonVein.net lungs-0758
Chronic eosinophilia is characterised by alveolar filling with eosinophils and inflammatory exudates(a) and interalveolar interstitial thickening, (overlaid in red in b). The infiltrates are classically peripherally positioned, usually upper lobes, more commonly bilateral but can be unilateral, and manifest as consolidation and or ground glass opacities. The CT shows a peripheral consolidation in the left upper lobe
Ashley Davidoff MD The CommonVein.net lungs-0764
The ground glass changes are a combination of the cellular and exudative inflammatory response in the small airways, alveoli, interalveolar septa and interstitium, and thickened alveolar septum
The diagram shows the abnormal secondary lobule (a) The involved components include the small airways(b) alveoli and interalveolar interstitium (c) and the thickened interlobular septum (d) surrounding the secondary lobule due to an inflammatory process, cellular infiltrate and congestion of the venules and lymphatics in the septum. An anatomic specimen of a secondary lobule from a patient with thickened interlobular septa and interstitial thickening is shown in image e, and is overlaid in red (f) . A magnified view of an axial CT of the lungs in a patient with acute eosinophillic pneumonia shows thickened interlobular septa and centrilobular nodules (g) The inflammatory changes in the aforementioned structures result in an overall increase in density of the lung manifesting as ground glass changes (g) and overlaid in red (h)
Ashley Davidoff MD The CommonVein.net lungs-0762
The diagram shows the small airways of the lung including the respiratory bronchiole, alveolar ducts and alveolar sacs in coronal (a) and in cross section (b) and correlated with an anatomic specimen of a secondary lobule that contains a thickened interlobular septum . The respiratory bronchiole is overlaid in maroon (d), next to the arteriole. Images e and f are magnified views of a CT of the lungs in a patient with acute eosinophillic pneumonia and the centrilobular nodules reflecting small airway disease are highlighted in f.
Ashley Davidoff MD The CommonVein.net lungs-0760b
The diagram shows the thickened septum surrounding the secondary lobule due to an inflammatory process, cellular infiltrate and congestion of the venules and lymphatics in the septum (a) . An anatomic specimen of a secondary lobule from a patient with thickened interlobular septa is shown in c and overlaid in d. CT of the lungs in a patient with acute eosinophillic pneumonia shows thickened interlobular septa and centrilobular nodules and the thickened septa are overlaid in red (e).
Ashley Davidoff MD The CommonVein.net
lungs-0761
Chronic eosinophilia is characterised by alveolar filling with eosinophils and inflammatory exudates(a) and interalveolar interstitial thickening, (overlaid in red in b). The infiltrates are classically peripherally positioned, usually upper lobes, more commonly bilateral but can be unilateral, and manifest as consolidation and or ground glass opacities. The CT shows bilateral peripheral consolidations in the upper lobes
Ashley Davidoff MD The CommonVein.net lungs-0775e