Bronchiectasis

Tuberculous spondylitis (Pott disease). A vertebral body is almost completely replaced by tuberculous tissue. Note the preservation of the intervertebral discs.

Mycobacterium tuberculosis. A smear of a pulmonary lesion shows slender, beaded, acid-fast bacilli.

Invasive aspergillosis. A section of lung impregnated with silver shows branching fungal hyphae surrounding blood vessels and invading the adjacent parenchyma.

Asthma. The airways typically show mucus plugging.

Asthma. Mucous plug with intraluminal inflammatory cells and hyperplasia of airway smooth muscle.

Asthma. The inflammatory cell infiltrate, predominantly eosinophils, extends focally into airspaces.

<bold>Figure 35.5</bold> The child with asthma uses a peak flow meter and keeps track of readings on a daily basis.

FIGURE 1.37. Computed tomography (CT) diagnosis of bronchiectasis. High-resolution CT shows multiple cylindrically dilated bronchi that are not tapering. The diameter is substantially greater than that of adjacent pulmonary vessels (arrows).

FIGURE 14.1. The spectrum of bronchiectasis. The chest x-ray film (A) of a patient with idiopathic bronchiectasis is relatively unremarkable despite the fact that bronchiectasis is seen on an accompanying computed tomographic (CT) scan (B). The patient had obstructive lung disease with persistent bilateral basilar crackles. In contrast, the chest x-ray film (C) of a patient with postinfectious bronchiectasis shows diffuse dilated air spaces that are also well seen on CT scan (D). This patie...

FIGURE 14.2. The signet ring sign. The diagram shows the relationship of the dilated bronchiole and small accompanying pulmonary artery that form a "signet ring" (indicated by an arrow in the computed tomographic scan).

Bronchiectasis. The resected upper lobe shows widely dilated bronchi, with thickening of the bronchial walls and collapse and fibrosis of the pulmonary parenchyma.

Necrotizing granuloma due to M. tuberculosis. A small tuberculous granuloma with conspicuous central caseation is present in the pulmonary parenchyma.

Cavitary tuberculosis. The apex of the left upper lobe shows tuberculous cavities surrounded by consolidated and fibrotic pulmonary parenchyma, which contains small tubercles.

Miliary tuberculosis. Multiple millimeter-sized nodules are scattered throughout the lung parenchyma.

Aspergillus fungus ball. The lung contains a cavity filled with a fungus ball.

Allergic bronchopulmonary aspergillosis. A dilated bronchus is filled with a mucous plug, which has dense layers of eosinophilic infiltrates.

Panacinar emphysema. This lung, from a patient with alpha 1-antitrypsin deficiency, shows large, irregular air spaces and a markedly reduced number of alveolar walls.

FIGURE 20.3. Chest radiograph (posteroanterior view only) demonstrating the radiographic presentation of miliary tuberculosis.

FIGURE 20.4. Chest radiographs (posteroanterior and lateral views) demonstrating cavitary reactivation of latent tuberculosis infection in the posterior apical segment of the right upper lobe.

Figure 189.1. Chest radiograph demonstrating apical infiltrate with cavitation, typical of pulmonary tuberculosis.

FIGURE 66.1. Photomicrographs of a sputum sample from an asthmatic patient. All of the micrographs were taken of unstained sputum samples pressed between a cover slip and a clear microscope slide. A sample was observed using the 40X objective and the 10X eyepiece. The final magnification of the micrographs is 1860X. (A) The broad arrow points to the brush border of a ciliated epithelial cell. Note the cell's apical nucleus and its pointed tail, which serves to fix the cell to the basement m...

FIGURE 66.1. Photomicrographs of a sputum sample from an asthmatic patient. All of the micrographs were taken of unstained sputum samples pressed between a cover slip and a clear microscope slide. A sample was observed using the 40X objective and the 10X eyepiece. The final magnification of the micrographs is 1860X. (A) The broad arrow points to the brush border of a ciliated epithelial cell. Note the cell's apical nucleus and its pointed tail, which serves to fix the cell to the basement m...

FIG. 2.2. Pulmonary complications. A: Sublobar atelectasis. Asthmatic child with acute asthma attack. Note area of apparent consolidation in the right paratracheal region (arrows). This represents collapse of one portion of the right upper lobe. A subtler finding assisting interpretation is that the minor fissure is slightly elevated. B: Pneumomediastinum. Asthmatic child with pneumomediastinum with air surrounding the small triangular thymus gland (T), extending as linear sheaths into the ...

FIG. 2.2. Pulmonary complications. A: Sublobar atelectasis. Asthmatic child with acute asthma attack. Note area of apparent consolidation in the right paratracheal region (arrows). This represents collapse of one portion of the right upper lobe. A subtler finding assisting interpretation is that the minor fissure is slightly elevated. B: Pneumomediastinum. Asthmatic child with pneumomediastinum with air surrounding the small triangular thymus gland (T), extending as linear sheaths into the ...

FIG. 2.2. Pulmonary complications. A: Sublobar atelectasis. Asthmatic child with acute asthma attack. Note area of apparent consolidation in the right paratracheal region (arrows). This represents collapse of one portion of the right upper lobe. A subtler finding assisting interpretation is that the minor fissure is slightly elevated. B: Pneumomediastinum. Asthmatic child with pneumomediastinum with air surrounding the small triangular thymus gland (T), extending as linear sheaths into the ...

<bold>Fig C 1-24 Pulmonary edema in pulmonary emphysema.</bold> (A) Initial chest radiograph demonstrates a paucity of vascular markings in the right middle and upper zones along with increased interstitial markings elsewhere. (B) With the onset of congestive heart failure, there is patchy interstitial and alveolar edema that does not affect the segments in which the vascularity had been severely diminished.

<bold>Fig C 42-5. Allergic bronchopulmonary aspergillosis.</bold> This woman with a history of asthma shows impaction of dilated large airways, producing the "finger-in-glove" sign (large arrows). There is also impaction of dilated small airways, producing the "tree-in-bud" pattern (small arrows).⁶³

PA chest x-ray showing lung hyperinflation in a patient with COPD

Lateral chest x-ray showing increased A-P diameter in a patient with COPD

<bold>Figure 4.131. Asthma in a child. A,</bold> frontal and <bold>B,</bold> lateral views show hyperinflation. There is peribronchial cuffing (<i>arrows</i>). Note the flat diaphragm in <bold>B.</bold>

CT scan showing pneumothorax in patient with COPD