IPLab:Lab 3:Foreign Body Granuloma

Clinical Summary

This 21-year-old black male suffered a gunshot wound to his right chest. A thoracotomy revealed multiple bleeding points in the middle and lower lobe of the right lung and significant hemorrhage from an intercostal artery. A portion of the right middle lobe was removed. The patient's post-operative course was complicated by Gram-negative pneumonia and significant neurologic dysfunction, apparently the result of emboli from iliofemoral venous thrombosis. All were treated without sequelae.

Images

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  This is a low-power photomicrograph of lung and pleura. There is some hemorrhage in this tissue (arrows), probably the result of surgery or the gunshot wounds.
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  This higher-power photomicrograph demonstrates the small focal cellular lesions (arrows) found throughout the parenchyma of the lung.
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  A higher-power photomicrograph of these granulomas reveals that they surround blood vessels (note the red blood cells within the lumen) (arrow).
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  This is a photomicrograph of lung taken under light that is partially polarized to demonstrate the birefringent particles within the granulomas (1). Also, at this magnification one can better appreciate that these granulomas are adjacent to blood vessels (2).
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  This is a fully-polarized view of lung showing numerous birefringent particles.

A thoracotomy is a surgical procedure in which an opening is made in the chest wall.

In alcoholics, aspiration pneumonia is common--bacteria enter the lung via aspiration of gastric contents.

Plural of embolus. An embolus is something that blocks the blood flow in a blood vessel. It may be a gas bubble, a blood clot, a fat globule, a mass of bacteria, or other foreign body. It usually forms somewhere else and travels through the circulatory system until it gets stuck.

Thrombosis occurring in the deep veins of the legs is a common sequela seen post-operatively.