Grippi Michael - Fishman’s Pulmonary Diseases and Disorders, Fifth Edition

The background image was obtained using three-dimensional, micro-computed tomography (micro-CT) on a lung specimen from a normal donor. Airways and blood vessels are shown penetrating alveolar ducts and alveoli. Imaging was performed at 8-m isotropic resolution (McDonough JE, Yuan R, Suzuki M, et al. Small-airway obstruction and emphysema in chronic obstructive pulmonary disease. N Engl J Med. 2011;365(17):15671575. PMCID: PMC3238466). The clinical CT images in the insets are still frames captured from the corresponding online video, which can be accessed by scanning the adjacent QR code. The top image, a maximum-intensity projection of a reformatted coronal section, shows contrast-enhanced pulmonary vasculature. The bottom image, a volume rendering of a similar reformatted coronal section using inverted gray scale, reveals the airways.

The initial portion of the video, comprised of a coronal view from a contrast-enhanced chest CT scan obtained from a normal, 25-year-old woman, shows volume rendering of the bony thorax and pulmonary vasculature. The video transitions to volume rendering of the lungs, trachea, and bronchi. Shown subsequently is a rotating tomographic section of the distal airways. A red box in the section indicates the general location from which a lung specimen was obtained from a separate, normal donor for micro-CT imaging. The last segment of this portion of the video shows rectangular volume rendering of the specimen, which then transitions to a rotating tomographic depiction. Blood vessels (solid arrow), alveolar ducts (dashed arrow), and alveoli (dotted arrow) are identified. The second portion of the video demonstrates an unenhanced CT scan from a 63-year-old female lung transplant recipient who had severe COPD. The patients chest x-ray is shown on the left and axial CT images on the right. The red box indicates the location from which a specimen was obtained from the explanted emphysematous lung for micro-CT imaging. The micro-CT segment in the video includes rectangular volume rendering of the emphysematous lung specimen and, subsequently, a rotating tomographic section of the tissue sample. Loss of alveolar structure is evident. Blood vessels (solid arrow), alveolar ducts (dashed arrow), and alveoli (dotted arrow) are noted. In this specimen, blood vessels are filled with residual blood.

Images courtesy of James C. Hogg, MD, PhD, John E. McDonough, PhD (both from the University of British Columbia), Joel D. Cooper, MD, Warren B. Gefter, MD, Michael A. Grippi, MD, Pablo G. Sanchez, MD, Drew A. Torigian, MD, and Alexander C. Wright, PhD (all from the University of Pennsylvania).

Copyright 2015 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.

ISBN: 978-1-25-958912-6
MHID: 1-25-958912-9

The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-179672-9, MHID: 0-07-179672-X.

eBook conversion by codeMantra
Version 1.0

All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps.

McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales promotions or for use in corporate training programs. To contact a representative, please visit the Contact Us page at www.mhprofessional.com.

TERMS OF USE

This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill Educations prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms.

THE WORK IS PROVIDED AS IS. McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill Education and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.