{"id":2215,"date":"2024-11-22T20:05:26","date_gmt":"2024-11-23T01:05:26","guid":{"rendered":"https:\/\/wordpress.forensicpath.us\/?p=2215"},"modified":"2024-11-23T16:38:59","modified_gmt":"2024-11-23T21:38:59","slug":"pathology-cases-bilateral-pulmonary-thromboemboli-following-an-airplane-flight","status":"publish","type":"post","link":"https:\/\/wordpress.forensicpath.us\/index.php\/2024\/11\/22\/pathology-cases-bilateral-pulmonary-thromboemboli-following-an-airplane-flight\/","title":{"rendered":"Pathology cases: Bilateral pulmonary thromboemboli following an airplane flight"},"content":{"rendered":"

A middle-aged man flew from Australia to the US.\u00a0 He complained of leg pain for a week and then suffered a witnessed collapse.\u00a0 At autopsy, bilateral occlusive thromboemboli were found in both main pulmonary arteries.<\/p>\n

Here are some pics from the gross exam:<\/p>\n

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The poplieal fossae were explored, and both the greater and lesser saphenous veins *and* the popliteal veins had significant clots bilaterally.<\/p>\n

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Here’s a low power view of the right main pulmonary artery.\u00a0 It’s hard to get a good section if you are cutting the tissue fresh.\u00a0 The clot will tend to pop out and the pulmonary artery is not real stable under the knife. If you want a really good demonstrative histologic section, it’s better to fix the tissue first.\u00a0 Unfortunately, we all know what the workload issues are, and I really didn’t have the time to wait.\u00a0 So, this is from a fresh section.\u00a0 On gross examination, as you can see above, there was complete occlusion, even though on histology it’s only about 50%.<\/p>\n

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Here’s a close up of the clot, showing the layers of fibrin with inflammatory cells and red cells, forming the classic “Lines of Zahn.”<\/p>\n

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If the clot’s been there for awhile, you will see organization moving in from the vascular wall.\u00a0 In this case there was only a hint of early reaction.<\/p>\n

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CPR had been attempted, and there were a couple of broken ribs.\u00a0 I’ve shown pictures of lipid emboli in the lungs before, and there were a couple here as well:<\/p>\n

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Something a little different, though, were innumerable small vacuoles in other organs as well — the kidney, the liver, and the brain.\u00a0 Here’s an example from the liver.\u00a0 That’s a little unusual for me.\u00a0 Maybe it’s due to altered circulation due to blockage of most flow to the lungs…<\/p>\n

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As always, images are free to use with or without attribution, though attribution is appreciated.\u00a0 If higher resolution images are required, send me an email.<\/p>\n","protected":false},"excerpt":{"rendered":"

A middle-aged man flew from Australia to the US.\u00a0 He complained of leg pain for a week and then suffered…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[99,108,60],"tags":[59,56,75,65],"class_list":["post-2215","post","type-post","status-publish","format-standard","hentry","category-forensic-pathology","category-gross-pathology","category-photomicrographs","tag-autopsy","tag-histology","tag-liver","tag-lung"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2215","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=2215"}],"version-history":[{"count":3,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2215\/revisions"}],"predecessor-version":[{"id":2232,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2215\/revisions\/2232"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=2215"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=2215"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=2215"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}