Lung bleb

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Lung bleb, also pulmonary bleb, are benign cystic lung lesions.[1]

Lung bleb. H&E stain.

Lung bulla and lung bullae redirect to this article.

General

Clinical history:

Gross

Cystic lesions:[2]

  • Bleb <=1 cm.
  • Bulla >1 cm, wall-thickness <= 1 mm.

Microscopic

Features:

  • Thin-wall cystic lesions.
    • Blebs are entirely intrapleural.[3]

DDx:

Images

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Lung, Left Upper Lobe, Lobectomy:
- SQUAMOUS CELL CARCINOMA.
-- Margins clear.
-- See tumour summary.
- Two lymph nodes NEGATIVE for malignancy (0/2).
- Emphysematous changes and bullous disease/belbs.

Note:

  • Using "bullous disease/belbs" skates around the size criteria that differentiates belbs from bullae.

Block letters

BLEBS, APEX OF THE LEFT LUNG, WEDGE RESECTION:
- BENIGN LUNG BLEBS.
- ABUNDANT PIGMENTED AIRSPACE MACROPHAGES.
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show peripheral lung with large dilated air spaces, surrounded by thin walls and lined by respiratory-type epithelium. Pigmented airspace macrophages are increased (smoker's macrophages). Focal fibrous pleural thickening is present. No significant inflammation is present. No interstitial fibrosis is present.

References

  1. Ryu, JH.; Swensen, SJ. (Jun 2003). "Cystic and cavitary lung diseases: focal and diffuse.". Mayo Clin Proc 78 (6): 744-52. doi:10.4065/78.6.744. PMID 12934786.
  2. Hansell, DM.; Bankier, AA.; MacMahon, H.; McLoud, TC.; Müller, NL.; Remy, J. (Mar 2008). "Fleischner Society: glossary of terms for thoracic imaging.". Radiology 246 (3): 697-722. doi:10.1148/radiol.2462070712. PMID 18195376.
  3. Leslie, Kevin O.; Wick, Mark R. (2004). Practical Pulmonary Pathology: A Diagnostic Approach (1st ed.). Churchill Livingstone. pp. 787. ISBN 978-0443066313.