An otherwise well 68 year old woman presents at the Emergency Department with fever and shortness of breath.A chest-x-ray shows patchy lung infiltrates bilaterally.A pneumonologist is consulted,who then performs a bronchoscopic biopsy,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

Question

Quizplus · Accepted Answer

The chest x-ray suggests bronchopneumonia,as does the clinical history.The biopsy (which probably wasn't necessary,but useful in order to ask the question)shows an acute inflammatory infiltrate focus on a small bronchiole,but also involving surrounding alveolar spaces.In lobar pneumonia,bronchial involvement is usually not seen.

An Otherwise Well 68 Year Old Woman Presents at the Emergency