Custom Search

 

Pathology of Bronchopneumonia

 Dr Sampurna Roy MD




 

Bronchopneumonia is a common community acquired pneumonia and is characterized by patchy exudative consolidation of lung parenchyma due to terminal bronchiolitis with consolidation of peribronchial alveoli. Images (slide show) Dr Yale Rosen  

Causative organisms:   

Visit: Pulmonary Pathology Online

1)  Staphylococci ; 2) Streptococci  ; 3) Pneumococci ; 

4) Haemophilus influenzaea ; 5) Pseudomonas aeruginosa ; 

6) Coliform bacteria .

Visit: Lobar Pneumonia ; Pulmonary Infection ; Pneumocystis Pneumonia

Clinical:

Patients present with fever, cough and purulent sputum.

Etiology:

- Bronchopneumonia is common in hospitalized patients.

- Bronchopneumonia may occur as a complication of some disease.

Example:

In children - Diphtheria ; Measles ; Whooping Cough .

In adults -  Influenza ; typhoid & paratyphoid fever etc.

- It is often seen in two extremes of life (in infants & old age).

- Most bronchopneumonia cases are caused by organisms aspirated from the mouth.

Predisposing factors:

Some patients are unable to clear their lungs due to medication, old age, physical weakness and pulmonary fibrosis.

Patients who are immobile develop retention of secretions; thus, most commonly involves the lower lobes.

Cilia not functioning - hereditary dyskinesis,  squamous metaplasia, cigarette smoking, gas exposure.

Alcohol, tobacco and oxygen therapy interfering with the ability of the alveolar macrophages to kill bacteria.

Bacteria grow within secretions collected in the chest.  

Example: In chronic bronchitis, cystic fibrosis or an obstructing malignant tumour.

Pulmonary edema fluid is a good culture media.

Pathogenesis:

There is initial terminal bronchiolitis with patchy consolidation of peribronchial lung tissue.

Bronchioles are plugged by the swollen mucosa and their secretion. As a result  air cannot enter the alveoli.

The imprisoned air in the alveoli is absorbed causing collapse of the alveoli.

Collapsed areas are surrounded by areas of compensatory emphysema.

[Consolidated areas are surrounded, from inside outwards, by areas of congestion, collapse and emphysema ].

Resolution of the exudate usually restores normal lung structure.

Organization may occur and result in fibrous scarring  in some cases.

Aggressive disease may produce abscesses.

Gross:  

Image1; Image2 ; Image3  ; Image4 (Dr Yale Rosen) 

1. Bilateral (less often unilateral), gray-red, patchy consolidation with intervening normal lung tissue.

2. Nodular, elevated, edematous to hemorrhagic-purulent areas.

3. Lesion is more extensive at the base of the lung and often fuses together resembling lobar pneumonia (confluent bronchopneumonia).

Microscopic feature:   

1. Bronchial wall is infiltrated with polymorphs, blood vessels are congested and bronchial lumen contains pus and desquamated epithelium. (Bronchocentric lesion)

2. Peribronchial lung alveoli are consolidated with purulent exudates (polymorphs & fibrin).

3. Escherichia coli pneumonias are mostly interstitial.

4. Parenchymal destruction depends on the organism .

Complications:

1. Pulmonary fibrosis.

2. Bronchiectasis

3. Lung abscess

4. Empyema

5. Bacteraemia with abscess in other organs

                                                                                               

November 2015

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

Histopathology-India.net

Dermpath-India

Dermato pathology Cases

Pathopedia-India.com

Surgical-Pathology.com

Pathology-India.com

Pancreatic Pathology Online

Gallbladder Pathology Online

Paediatric Pathology Online

Paraganglioma-Online

Endocrine Pathology Online

Eye Pathology Online

Ear Pathology Online

Cardiac Path Online

Lung Tumour-Online

Mesothelioma-Online

Pulmonary Pathology Online

Nutritional Pathology Online

Environmental Pathology Online

Pathology Quiz Online

GI Path Online

Soft Tissue Pathology

Case Index

Infectious  Disease Online

E-book - History of  Medicine with special reference to India

Microscope Seeing the  Unseen

 

submit to reddit

 

Tetanus

Tick-borne Encephalitis

Toxic Shock Syndrome

Toxoplasmosis

Trachoma


   Disclaimer  ;  Privacy Policy  ; Advertising Policy  ;  E-mail 

           Copyright 2016  histopathology-india.net
           All rights reserved