Question
A 76-year-old woman is brought to the emergency department because of the sudden onset of two episodes of hemoptysis and left-sided chest pain, which is exacerbated upon inspiration. Her temperature is 38°C (101°F), pulse 110 per minute, respirations 35 per minute, and blood pressure 158/100 mm Hg. The patient is admitted, but suffers a massive stroke and expires 48 hours later. Autopsy reveals a pulmonary infarct in upper segments of the lower lobe as shown in the image. Which of the following best explains the color of this patient’s pulmonary infarct?
| A. |
Accumulation of hemosiderin-laden macrophages
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| B. |
Development of bronchopneumonia
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| C. |
Hemorrhage from bronchial arteries
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| D. |
Organization of a pulmonary thromboembolus
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Show Answer
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Correct Answer � C
Explanation
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Correct answer : c Hemorrhage from bronchial arteries
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The gross and microscopic appearance of an infarct depends on its location and age. Pale infarcts are typically seen in the heart, kidneys, and spleen. Red infarcts may result from either arterial or venous occlusion.
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They are distinguished from pale infarcts by bleeding into the necrotic area from adjacent arteries and veins. Red infarcts occur principally in organs with a dual blood supply, such as the lung, or those with extensive collateral circulation, such as the small intestine and brain.
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In the heart, a red infarct occurs when the infarcted area is reperfused, as may occur following spontaneous or therapeutically induced lysis of the occluding thrombus. Grossly, red infarcts are sharply circumscribed, firm, and dark red to purple. Over a period of several days, acute inflammatory cells infiltrate the necrotic area from the viable border.
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The cellular debris is phagocytosed and digested by polymorphonuclear leukocytes and later by macrophages. Granulation tissue eventually forms, to be replaced ultimately by a scar.
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None of the other choices would cause hemorrhage into an infarct.
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