Septal fibrosis

Fig. 21.14 Periportal and septal fibrosis following severe acute viral hepatitis B liver architecture clearly disrupted older collapse fields with condensed reticular fibres (Gomori s reticulin stain)...

Fig. 28.11 Chronic moderate periportal and portal inflammatory reaction with septal fibrosis and centrilobular steatosis in chronic alcoholic liver damage (DD mild chronic viral hepatitis C ) (van Gieson)...

Michalak, S., Rousselet, M.C., Bedossa, R, Rilette, C., Chappard, D., Oberti, F., Gallois, Y., Cales, R Respective roles of porto-septal fibrosis and centrilobular fibrosis in alcoholic liver disease. J. Path. 2003 201 55-62... 

A disease of epidemic proportions affected more than 1,000 persons in India in 1974. The patients suffered from jaundice and ascites. Histological examination revealed centroacinar necrosis, inflammatory mesenchymal reactions and bile-duct proliferation fibrosis and septal formation, sometimes ultimately cirrhosis, were determined. Mortality was 10%. The cause was thought to be the additive effect of several unidentified mycotoxins (B.N. Tandon et al., 1977). 

Fig. 32.13 PSC marked concentric fibrosis around a septal bile duct as well as slight periportal inflammation (HE)...

Stage ni The septal stage displays periportal and bridging necrosis as well as an increasing loss of bile ducts with a simultaneous decline in portal inflammatory infiltrations. Dense concentric fibrosis develops around... 

Fig. 32.17 Congenital liver fibrosis onset of drrhotic transformation, pathologically augmented bile-duct aggregates in portal and septal areas (Sirius red)...

Fig. 33.3 Autoimmune hepatitis in remission under treatment with septal fibrosis and disarranged lobular structure...

Fig. 34.5 Chronic, mildly active hepatitis B with pronounced periportal and septal fibrosis (as a sequela of previous inflammatory episodes)...

A healthy 5-year-old girl, who had taken large doses of oral ferrous sulfate 300 mg five times a day (300 mg of elemental iron/day) for 5 years, developed severe hemosiderosis (29). Liver biopsy showed preserved lobular architecture, but the portal tracts were expanded by fibrosis and there was mild septal fibrosis. There was siderosis of the hepatic parenchymal cells and hemosiderin deposition in the Kupffer cells. She had no under-Ijdng hematological disease and her iron absorption was normal. HLA phenotypes and DNA analysis for the most common mutations associated with hemochromatosis excluded homozygous and heterozygous hereditary hemochromatosis. She was successfully treated by phlebotomy. Iron studies 10 years later were normal. 

Figure 3.31 Typical pattern of repolarisation (deep negative and rather symmetrical and narrow T wave) frequently seen in patients with hypertrophic cardiomyopathy of apical type. The absence of septal q wave is explained by the presence of septal fibrosis (CE-CMR) and the deep negative T wave by craniocaudal asymmetry of septum (Dumont, 2006). A tall R wave is usually seen from V2-V3 to V5-V6 without Q wave.

QS pattern in V1 and even in V2 in septal fibrosis, emphysema, the elderly, chest abnormalities, etc. Low progression... 

ECG recordings with QS morphology in V1-V2 may be seen due to septal fibrosis or in elderly patients. This pattern most probably corresponds to an old infarction when this is recorded in patients with chronic IHD and is accompanied by changes of repolarisation suggestive of ischaemia. The presence of Q waves in certain leads does not rule out the presence of viability in the correlated cardiac segments (Schinkel et al., 2002). 

In Palmer et al. (1973), rats, mice, and hamsters, were exposed to radon [4.8x10 pCi radon/L of air (1.8x10 Bq/m )] via inhalation for approximately 90 hours per week, in two continuous 45-hour periods. These animals were allowed to die, or were sacrificed when moribund, after which they were histopathologically examined. At four months of exposure, only one of the rodents remained alive. The radiation effects observed in these animals, which included interstitial pneumonitis or septal fibrosis, were found at post-mortem examination. Therefore the onset of respiratory effects could not be determined. 

Brant WO, Bella AJ, Garcia MM et al (2007) Isolated septal fibrosis or hematoma-atypical Peyronie s disease J Urol 177 179-182 discussion 183... 

Most of patients with circumscribed cavernosal fibrosis or scar have had penile surgery or traumas. Postraumatic fibrosis usually results from healing of intracavernosal hematoma (Bertolotto and Pozzi Mucelli 2004 Munarriz et al. 2005) or rupture of the tunica albuginea from sudden bending of the erect penis. A recent report (Brant et al. 2007) describes a subset of patients with penile induration who were found to have only a circumscribed septal fibrotic change on penile ultrasonography. About 36% of these patients had a significant history of penile trauma. 

Circumscribed septal fibrosis presents at ultrasound as an alteration of the normal ultrasonographic appearance of the penile septum (Fig. 18.4), which is replaced by inhomogeneous echogenic tissue (Brant et al. 2007). 

Fig. 18.4. Circumscribed septal fibrosis. Axial scan showing inhomogeneous echogenic tissue arrowheads) within the penile septum...

Absence of dense interstitial fibrosis Organizing pneumonia is not the prominent feature Diffuse, severe alveolar septal inflammation is absent Fibrosing pattern ... 

Histopathologically, DIP is characterized by filling of alveolar spaces with pigmented alveolar macrophages (Fig. 3). Parenchymal involvement seen in DIP is more extensive and uniform compared with that of RB-ILD, but the histologic distinction between these two entities may at times be difficult (1,8,10). Alveolar septal fibrosis and mild interstitial inflammation may be present, but honeycomb change is unusual. Fibroblast foci are not seen. Compared with RB-ILD, DIP exhibits greater extent of interstitial fibrosis, lymphoid follicles, and eosinophilic infiltration (15). 

Alveolar septa may show some degree of expansion due to capillaritis, edema, and/or interstitial fibrosis (84,85). Capillaritis, characterized by neutrophils within the septa, is usually focal and of mild to moderate intensity. Diffuse or prominent capillaritis, or vasculitis of larger blood vessels is atypical, and if present, suggests another disease process. When interstitial fibrosis is present, it too is usually patchy and mild. Type II pneumocytes may show hyperplasia and reactive atypia in response to alveolar damage. In some cases, hyaline membranes are seen focally (85). Ultrastructural studies have shown fragmentation of alveolar septal basement membranes and wide gaps between endothelial cells (90). 

Ischemic Heart Disease (IHD) Myocardial Infarction (MI) Normal variant Cardiomyopathy Fibrosis of condnction system Hypertension Pnlmonary Embolism Atrial Septal Defect (ASD) Congenital heart disease... 

The common thin-section CT findings of graphite pneumoconiosis include small nodules, interlobular septal thickening, and the prevalence of large opacities (progressive massive fibrosis). Small nodules are classified into two patterns ill-defined tiny opacities that appear either as fine branching opacities... 

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