16451              LOBAR PNEUMONIA

The patient was a man aged 67.  Twenty months before his death chronic lymphatic leukaemia was discovered and was treated with chlorambucil.  He subsequently developed weakness and ataxia in the legs with an erythematous rash and massive lymphadenopathy in the neck.  Radiotherapy was given and he improved.  He was re-admitted a month before his death and while in hospital he developed a pneumococcal respiratory infection.  At that time treatment was by Cyclophosphamide.  Lobar pneumonia was diagnosed and he died two days later.  At postmortem there was disseminated lymphosarcoma, and lobar pneumonia in the left lung.

The specimen is this left lung sectioned to show uniform massive grey hepatization of the entire upper lobe and a similar area of grey consolidation in the apical segment of the lower lobe.  The pneumonic process is limited by the interlobar septum except posteriorly.  The remainder of the lower lobe appears normal.  There is some acute overlying fibrinous pleurisy most evident on the lateral aspect of the subapical region and over the apical and posterior basal segments of the lower lobe.  Histology shows classical lobar pneumonia in the stage of grey hepatization.  There is a good polymorph response in the exudate.