Case 66. Aspiration pneumonia (69 y-o F)
　 　 　 　 　
　 　
Pneumonia seen in a dysphagic patient suffering from esophageal cancer
 　 　
　 　 　 　 　
　 　
Key words : Aspiration pneumonia, E. coli, lung gangrene
 　 　
　 　 　 　 　
　 　
opportunistic infection
 　 　
　 　 　
　
　 　 　
The pneumonia focus shows marked phagocytic activation. Nuclear dusts are easily noted (HE). 　 E. coli antigens (lipopolysaccharides) are demonstrated in the cytoplasm of phagocytic cells (immunostaining). Opportunistic infection of Gram-negative enteric bacteria is indicated.
　 　 　
　
　 　 　
Reference case 66A
Foreign body granulomatous reaction around the respiratory bronchiole (HE).　In this case, bronchopneumonia is associated with foreign body reaction against aspirated food material. Pathogens are commonly anerobic oral flora, including Streptococcus viridans group.		 　 Reference case 66B
Severe combined pneumonia provoked by prolonged infection of weakly pathogenic Gram-negative rods (gross findings).　The histologic features are intermediate between bronchopneumonia and interstitial pneumonia. This reflects prolonged carnification of the inflammatory alveolar exudates in dysphagic patients.
　 　 　
　 　
　 　 　
Reference case 66C
Lung gangrene, accompanying multiple fused cavities (gross findings). Strong corruptive smell is the feature of this condition.　Strong smell generally indicates infection of anerobic bacteria.