Introduction

Climbing Net Newton Center Massachusetts

Davidoff photography Davidoff art copyright 2012 110271p.8s

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This is a picture showing the similarity of the shape of the lobules and interlobular septa to the patterns on the skin of a giraffe

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Reticular Pattern on the Veins of a Leaf

Newton Center Davidoff photography copyright 2012 110325pc01.9s

Coleus Capillary Network

69077b01 Davidoff photography  Copyright 2012

Rectanguloid Shapes in the Water

This photograph shows ripples in the water reminiscent of the polygonal shape of the secondary pulmonary lobules.

Courtesy Ashley Davidoff M.D. 69997 Davidoff photography Copyright 2012 Purity Spring NH

Dragonfly Rectanguloid Structure of the Wings

110306p.8  Courtesy Betsy Barry 2012 110306p.8

Tectanguloid Shapes in Nature

This is a series of images demonstrating the shape of the secondary lobule. The first image (1) is a post mortem specimen with congested lungs showing the interlobular septa, while the next (2), is an overlay of the septa in white showing their polygonal shape. The next drawing reveals side-by-side secondary lobules with central bronchovascular bundles and peripheral lymphovascular bundles. Image 4 is a CT image through the apex of the lung showing thickened secondary lobules in a patient with mild emphysema, and 5 shows marked thickening of the interlobular septa in a patient with end stage sarcoidosis. 6,7,8 show the shape of the secondary lobules in the skin of a giraffe, the bark of a pine, and the ripples of the water respectively.

Courtesy Ashley Davidoff MD Copyright 2012   31866collage_1

Prominent Secodary Lobules in the Lung

In this high resolution CTscan at the apex of the left lung the secondary lobule is seen with 3 sets of bronchovascular bundles at the door of the secondary lobule surrounded by the interlobular septa in which the pulmonary venules and lymphatics run. This patient had mild emphysema and it was surprising to find this beautiful example of a pulmonary lobule in a patient who was almost normal. We suspect that with the higher resolution technology we will see the normal (or almost normal) pulmonary lobule with greater frequency.

Courtesy Ashley Davidoff MD 31819

Rectanguloid Histology of the Secondary Lobule

This image is a panoramic view of the lung showing in this case almost rectangular secondary lobules surrounded by interlobular septa (cream borders) The distal bronchioles (teal) and pulmonary arteriole (royal blue are shown in the centre of a lobule in the right lower corner. The branches of these two structures are shown in the secondary lobule with the acinar airways shown in teal and the presumed course artistically inferred in royal blue. Within the interlobular septa (light pink) remnants of the pulmonary venules (red – inferred) and lymphatics (yellow inferred) course going in the opposite direction to the arteriole and the airways. Courtesy Armando Fraire MD.

Courtesy Ashley DAvidoff MD copyright 2012 all rights reserved 32649c06.8s

Reticular Pattern Heart Failure

Images from a normal (a nd c ) CXR in contrast to c and d which show the reticular pattern and Kerley B lines of heart failure

Courtesy Ashley Davidoff MD 42545c01.800

Magnification of Interstitial Lines in Heart Failure

This plain chest x-ray (CXR) reveals an enlarged heart and horizontal, non tapering lines in the costophrenic angles that are between 1-2cms., characteristic of Kerley B lines. These lines correspond to distended lymphatics of the interlobular septa and reflect elevated pressures of congestive cardiac failure (CHF) . Kerley C lines are characterised by a reticular pattern and are causes by a large number of Kerley B lines that overlap each other. Note the reticular pattern in this image.

42545 Courtesy Ashley Davidoff MD Copyright 2012