Abstract
Context:
Surgical and pathologic handling of lung physically affects lung tissue. This leads to artifacts that alter the morphologic appearance of pulmonary parenchyma.
Objective:
To describe and illustrate mechanisms of ex vivo artifacts that may lead to diagnostic pitfalls.
Design:
In this study 4 mechanisms of ex vivo artifacts and corresponding diagnostic pitfalls are described and illustrated.
Results:
The 4 patterns of artifacts are: (1) surgical collapse, due to the removal of air and blood from pulmonary resections; (2) ex vivo contraction of bronchial and bronchiolar smooth muscle; (3) clamping edema of open lung biopsies; and (4) spreading of tissue fragments and individual cells through a knife surface. Morphologic pitfalls include diagnostic patterns of adenocarcinoma, asthma, constrictive bronchiolitis, and lymphedema.
Conclusion:
Four patterns of pulmonary ex vivo artifacts are important to recognize in order to avoid morphologic misinterpretations.
MeSH terms
-
Adenocarcinoma / diagnosis
-
Adenocarcinoma / metabolism
-
Adenocarcinoma / pathology
-
Adenocarcinoma / surgery
-
Artifacts
-
Asthma / diagnosis
-
Asthma / metabolism
-
Asthma / pathology
-
Asthma / surgery
-
Biomarkers / metabolism
-
Biopsy / adverse effects
-
Bronchioles / metabolism
-
Bronchioles / pathology
-
Bronchioles / surgery
-
Bronchiolitis Obliterans / diagnosis
-
Bronchiolitis Obliterans / metabolism
-
Bronchiolitis Obliterans / pathology
-
Bronchiolitis Obliterans / surgery
-
Diagnosis, Differential
-
Diagnostic Errors / classification
-
Diagnostic Errors / prevention & control*
-
Humans
-
Lung / blood supply
-
Lung / metabolism
-
Lung / pathology*
-
Lung / surgery
-
Lung Diseases / diagnosis
-
Lung Diseases / metabolism
-
Lung Diseases / pathology*
-
Lung Diseases / surgery
-
Lung Neoplasms / diagnosis
-
Lung Neoplasms / metabolism
-
Lung Neoplasms / pathology
-
Lung Neoplasms / surgery
-
Lymphedema / diagnosis
-
Lymphedema / metabolism
-
Lymphedema / pathology
-
Lymphedema / surgery
-
Muscle Contraction
-
Muscle, Smooth / metabolism
-
Muscle, Smooth / pathology
-
Muscle, Smooth / surgery
-
Neoplasm Seeding
-
Respiratory Mucosa / blood supply
-
Respiratory Mucosa / metabolism
-
Respiratory Mucosa / pathology*
-
Respiratory Mucosa / surgery
-
Specimen Handling / adverse effects