IPLab:Lab 1:Lung Abscess: Difference between revisions - Pathology Education Instructional Resource

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This 67-year-old male with advanced colon cancer underwent palliative surgery to remove a bowel obstruction. During the surgery the patient had several episodes of hypotension and after surgery he required ventilator support. Four days later the patient developed a fever and his white blood cell count was 15,256 cells/mm3. A chest x-ray demonstrated infiltrates in both lungs, which worsened over the next several days. His overall condition continued to deteriorate and he died 12 days after surgery.

At autopsy, the lungs were markedly consolidated and had several focal abscesses that were 2 to 4 cm in diameter. Liquefied material poured out from these abscesses when the lungs were sliced.

~~== Autopsy Findings ==~~

At autopsy, metastatic colon cancer was found throughout the abdominal cavity and invading into the liver. The lungs were markedly consolidated and had several focal abscesses that were 2 to 4 cm in diameter. Liquefied material poured out from inside these abscesses when the lungs were sliced.

== Images ==

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File:IPLab1LungAbscess1.jpg|This is a gross photograph of the lungs from this case. Note the abscesses (arrows) especially in the lower lobes. The entire lung is consolidated.

File:IPLab1LungAbscess2.jpg|This is a closer view of the lung from this case. In this section of upper lobe there are multiple areas of early abscess formation (arrows). Note the circumscribed whitish-tan lesions. These lesions are filled with white blood cells.

File:IPLab1LungAbscess3.jpg|This low-power photomicrograph of lung from this case demonstrates one of the abscesses (arrows). Note that the material inside the abscess has been ~~expelled.~~

File:IPLab1LungAbscess3.jpg|This low-power photomicrograph of lung from this case demonstrates one of the abscesses (arrows). Note that the material inside the abscess has been degraded and removed. Note the loose necrotic material inside the abscess. This material is made up of inflammatory cells (primarily dead white blood cells) and necrotic lung tissue.

~~File:IPLab1LungAbscess4.jpg|This higher-power photomicrograph of lung demonstrates the edge of the abscess~~. Note the ~~loss of~~ material ~~from the center of~~ the abscess ~~(1) and loose necrotic material that has not been expelled (2)~~. This material is made up of inflammatory cells (primarily dead white blood cells) and necrotic lung tissue.

File:IPLab1LungAbscess5.jpg|This is a low-power photomicrograph of lung tissue containing a large abscess. The center of the abscess contains necrotic debris (1) and there is a rim of viable inflammatory cells (arrows) surrounding this abscess.

File:IPLab1LungAbscess6.jpg|This high-power photomicrograph demonstrates a small abscess (arrow) with a necrotic center.

File:~~IPLab1LungAbscess7~~.jpg|This high-power photomicrograph shows the center of ~~an abscess containing neutrophils and necrotic debris.~~

File:IPLab1LungAbscess8.jpg|This high-power photomicrograph shows the center of this abscess which contains inflammatory cells (primarily neutrophils) (arrows). There is a bacterial colony in the center of this abscess (1).

~~File:IPLab1LungAbscess8.jpg|A high-power photomicrograph of lung from~~ this ~~case demonstrates a small~~ abscess ~~full of~~ inflammatory cells (primarily neutrophils) (arrows). There is a bacterial colony in the center of this abscess (1).

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 This 67-year-old male with advanced colon cancer underwent palliative surgery to remove a bowel obstruction. During the surgery the patient had several episodes of hypotension and after surgery he required ventilator support. Four days later the patient developed a fever and his white blood cell count was 15,256 cells/mm3.  A chest x-ray demonstrated infiltrates in both lungs, which worsened over the next several days. His overall condition continued to deteriorate and he died 12 days after surgery.
 At autopsy, the lungs were markedly consolidated and had several focal abscesses that were 2 to 4 cm in diameter. Liquefied material poured out from these abscesses when the lungs were sliced.
-== Autopsy Findings ==
-At autopsy, metastatic colon cancer was found throughout the abdominal cavity and invading into the liver. The lungs were markedly consolidated and had several focal abscesses that were 2 to 4 cm in diameter. Liquefied material poured out from inside these abscesses when the lungs were sliced.
 == Images ==
@@ Line 10: / Line 7: @@
 File:IPLab1LungAbscess1.jpg|This is a gross photograph of the lungs from this case. Note the abscesses (arrows) especially in the lower lobes. The entire lung is consolidated.
 File:IPLab1LungAbscess2.jpg|This is a closer view of the lung from this case. In this section of upper lobe there are multiple areas of early abscess formation (arrows). Note the circumscribed whitish-tan lesions. These lesions are filled with white blood cells.
-File:IPLab1LungAbscess3.jpg|This low-power photomicrograph of lung from this case demonstrates one of the abscesses (arrows). Note that the material inside the abscess has been expelled.
+File:IPLab1LungAbscess3.jpg|This low-power photomicrograph of lung from this case demonstrates one of the abscesses (arrows). Note that the material inside the abscess has been degraded and removed. Note the loose necrotic material inside the abscess. This material is made up of inflammatory cells (primarily dead white blood cells) and necrotic lung tissue.
-File:IPLab1LungAbscess4.jpg|This higher-power photomicrograph of lung demonstrates the edge of the abscess. Note the loss of material from the center of the abscess (1) and loose necrotic material that has not been expelled (2). This material is made up of inflammatory cells (primarily dead white blood cells) and necrotic lung tissue.
 File:IPLab1LungAbscess5.jpg|This is a low-power photomicrograph of lung tissue containing a large abscess. The center of the abscess contains necrotic debris (1) and there is a rim of viable inflammatory cells (arrows) surrounding this abscess.
 File:IPLab1LungAbscess6.jpg|This high-power photomicrograph demonstrates a small abscess (arrow) with a necrotic center.
-File:IPLab1LungAbscess7.jpg|This high-power photomicrograph shows the center of an abscess containing neutrophils and necrotic debris.
+File:IPLab1LungAbscess8.jpg|This high-power photomicrograph shows the center of this abscess which contains inflammatory cells (primarily neutrophils) (arrows). There is a bacterial colony in the center of this abscess (1).
-File:IPLab1LungAbscess8.jpg|A high-power photomicrograph of lung from this case demonstrates a small abscess full of inflammatory cells (primarily neutrophils) (arrows). There is a bacterial colony in the center of this abscess (1).
 </gallery>