（3）gray hepatization: 5th –6th day gross
gray-brown and solid, liver like consistency
LM
the alveolar capillaries appear compressed alveolar spaces: progressive disintegration of
• fibrinous inflammation • Symptoms: abrupt onset, high
fever, shaking chills, pleuritic chest pain, a productive mucopurulent cough ( “rusty” sputum )
Etiology
pathogens： streptococcus-pneumoniae, pneumobacillus
inducing factors: cold, excessive tired, anethesia Pathogenesis bacteria---alveoli---proliferate , capillary dilate, serious exudates---kohn’s pores---spreading entire lobe
mononuclear interstitinal infiltrates— viral/atypical pneumonias
granulomas/ cavitation — chronic pneumonias
1. Bacteria pneumonia (1) Lobar pneumonia
an acute bacterial infection of a large portion of a lobe or of an entire lobe
Chapter 9
Diseases of Respiratory System
9.1 Infection of respiratory tract
Acute tracherobronchitis Acute bronchiolitis Pneumonia
9.1.1 Acute tracheobronchitis
9.1.3 Pneumonia
broadly defined: any infection in the lung histologic spectrum-vary from
a fibrinopurulent alveolar exudate — acute bacterial pneumonia bronchopneumonia lobar pneumonia
an overlying fibrinous or fibrinosuppurative pleuritis
LM alveolar space: a flock of RBC, packed with fibrin nets which stream from one alveolus through the pores of kohn into adjacent alveoli, neutrophils
Acute suppurative tracheobronchitis. There is a significant element of leukocytic infiltration.
Acute ulcerative tracheobronchitis. The inflammatory reaction is more intense, with necrosis of the mucosa in areas, it constitutes an ulcerative form.
9.1.2 Acute bronchiolitis
The bronchioli mucosa is hyperemia and swelling with a lymphomonocytic and leukocytic infiltration of the submucosa accompanied by overproduction of mucous secretions.
neutrophils, RBC , and numerous bacteria
congestion sion: 3rd-4th days
gross
the lobe distinctly red, firm, and airless with a liver-like consistency
Bronchiolitis obliterans is characterized by polypoid masses of organizing inflammatory exudates and granulation tissue extending from alveoli into bronchioles
Pathologic changes （1）congestion stage：1st-2nd days the outpouring of a protein-rich exudate into alveolar spaces and rapid proliferation of bacteria. gross heavy, red, boggy LM alveolar wall: cap. dilate, congestion alveolar space: proteinaceous edema fluid, few
Acute catarrhal tracheobronchitis. The inflammatory exudate on the mucosal surface is chiefly a stringy, basophilic mucus only scantily mixed with leukocytes.