Ex Vivo Artifacts and Histopathologic Pitfalls in the Lung.

CONTEXT: Surgical and pathologic handling of lung physically affects lung tissue. This leads to artifacts that alter the morphologic appearance of pulmonary parenchyma.

OBJECTIVE

To describe and illustrate mechanisms of ex vivo artifacts that may lead to diagnostic pitfalls.

DESIGN

In this study 4 mechanisms of ex vivo artifacts and corresponding diagnostic pitfalls are described and illustrated.

RESULTS

The 4 patterns of artifacts are: (1) surgical collapse, due to the removal of air and blood from pulmonary resections; (2) ex vivo contraction of bronchial and bronchiolar smooth muscle; (3) clamping edema of open lung biopsies; and (4) spreading of tissue fragments and individual cells through a knife surface. Morphologic pitfalls include diagnostic patterns of adenocarcinoma, asthma, constrictive bronchiolitis, and lymphedema.

CONCLUSION

Four patterns of pulmonary ex vivo artifacts are important to recognize in order to avoid morphologic misinterpretations.