Two days later, however, several family members develop severe abdominal pain and diarrhea. You find that the stools of the affected members contain both blood and neutrophils. On a hunch, you perform a gram stain and detect numerous organisms with morphology sufficiently distinctive to make a diagnosis. The presence of hyaline membranes reflects diffuse alveolar injury. Hyaline membranes in premature infants are filled with lymphocytes.
Hyaline membranes arise from alveolar injury due to a variety of insults.
Diffuse alveolar injury in ARDS and in the respiratory distress syndrome of newborns arise by different pathogenic mechanisms. A 55 year-old man, chronic heavy smoker, presented with moderate hepatomegaly. He also appeared slightly icteric. Bronchoscopy revealed no evidence of intraluminal mass but showed slightly narrowed bronchial lumen. Biopsy is shown in the picture.