Lung bleb

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Lung bleb. H&E stain.

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

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.

See also

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.