20 - Lung

Summary

Inflammation in the lung is common in both physiologic responses as well as many respiratory illnesses. In particular, chronic inflammation is associated with a variety of prevalent disorders, including asthma, chronic obstructive pulmonary disease, bronchiectasis, and interstitial lung diseases [1 – 3]. For purposes of host defense, an overexuberant inflammatory response can also lead to respiratory disorders. For example, inhalation of pathogens, toxins, or specific allergens initiates an acute inflammatory response that characterizes acute exacerbations of bronchiectasis, COPD, and asthma [1, 4]. Perhaps the most extensively investigated example of acute inflammation and its spontaneous resolution is pneumonia. In this chapter, a common clinical presentation of pneumonia is provided with examples of its radiographic appearance and histology during both the initiation and resolution phases of the illness.

Bea Coffin is a 56-year-old woman who presents with a new cough and dyspnea. She has felt ill for about 3 days. Her cough is productive of blood-tinged green phlegm. She has also had fevers, chills, and sweats that are getting worse. The symptoms began with the sudden onset of right sided chest pain that makes it difficult to take a deep breath. She has tried acetaminophen and an expectorant, but these interventions have not been successful in controlling her symptoms. She is a lifelong nonsmoker and has no significant past medical history.