Medical Speech Pathology

Curiosity, Dialogue, and Knowledge

Bronchopulmonary Aspiration

The following pictures are courtesy of Yale Rosen, MD (a medical pathologist).  My thanks for these fascinating pictures!  If you are curious, click on any of the pictures to reveal a host of others attached to Dr. Rosen’s Flickr account.  As is true with some of the other pictures on this site, some of these slides are graphic images of the anatomy.

A microscopic view of aspirated vegetable material

Dr. Rosen describes the above slide as:

Aspirated vegetable material consisting of an ovoid structure representing the starchy content of edible seeds of certain pod-bearing plants, such as peas, beans, lentils, peanuts, carob, and soybeans. “Pulse” is the common botanical name of the Fabaceae (Leguminosae), a large plant family, called also the pea, or legume, family. These structures may incite the formation of granulomas often referred to as “pulse granulomas” in the medical literature. The absence of inflammatory reaction in this image indicates that aspiration was a terminal or pre-terminal event.

Microscopic slide of aspiration, undetermined foreign material

While the title of the above slide is “Aspiration, undetermined foreign material”, Dr. Rosen and a colleague entertain the possibility that, “Perhaps these are remains from some plant material as this (wooden) material is rigid and imperishable.”

A microscopic slide of aspirated barium

Aspirated barium is present within the centrally located bronchiole and in adjacent alveoli.

The above slide is of interest to those of use working as Speech Language Pathologists.  It is a microscopic view of aspirated barium.

I recently got permission from the New England Journal of Medicine to post a picture that I had previously linked.  Many thanks to them and to the authors,  Mazen Albeldawi, M.D., and Rohit Makkar, M.D., whose work appears below.  Click on the image to be redirected to the original photo and work.

A Chest X-Ray showing the inner anatomy of the lungs via contrast from barium

By Mazen Albeldawi, M.D., and Rohit Makkar, M.D.

A microscopic slide of amniotic fluid and meconium that has been aspirated into the lungs

Aspirated squames and meconium within a bronchiole and in adjacent alveoli

The above slide is of interest, as it is not uncommon to see respiratory problems in the Neonatal Intensive Care Unit (NICU) related to meconium aspiration.  Wikipedia defines Meconium below and in further detail here:

Meconium is the earliest stools of an infant. Unlike later feces, meconium is composed of materials ingested during the time the infant spends in the uterus: intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water. Meconium had been thought to be sterile until the team of researchers from the University of Valencia in Spain found bacterial communities in it so developed that they seemed to fall into two categories. Around half of the samples appeared to be dominated by bacteria that produce lactic acid, such as lactobacillus, while the other half mostly contained a family of so-called enteric bacteria, such as Escherichia coli. Meconium, unlike later feces, is viscous and sticky like tar, and has no odor. It should be completely passed by the end of the first few days of life, with the stools progressing toward yellow (digested milk). The term Meconium derives from meconium-arion, meaning “opium-like”, in reference either to its tarry appearance or to Aristotle’s belief that it induces sleep in the fetus.

Gross Anatomy Slide 1

A picture of the gross anatomy of the lungs showing aspiration of vomitis into the lungs

Aspirated vomitus occluding the main stem bronchi.

Gross Anatomy Slide 2

A gross anatomical view of corn that has entered into the lower airway

A gross anatomical view of corn that has entered into the lower airway

Gross Anatomy Slide 3

Gross anatomy vie of aspiration pneumonia

Foci of consolidation and abscess formation in the lower lobe.

The above slide is the gross anatomy view of aspiration pneumonia, and below is the microscopic view of aspiration pneumonia.

Aspiration Pneumonia Microscopic

Vegetable fragment infiltrated by polys. Although this structure is at an advanced stage of digestion/dissolution the outer cellulose wall is still visible.

For an opinion piece about feeding people at risk for aspiration pneumonia check out the editorial section here.


One comment on “Bronchopulmonary Aspiration

  1. Jessica Pollard
    September 19, 2015

    Thank you! Excellent to see it so clearly

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