{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:38:39Z","timestamp":1789702719219,"version":"4.0.1"},"reference-count":96,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Context.<\/jats:italic>\n                    \u2014Acute lung injury and acute respiratory distress syndrome are significant causes of pulmonary morbidity and are frequently fatal. These 2 entities have precise definitions from a clinical standpoint. Histologically, cases from patients with clinical acute lung injury typically exhibit diffuse alveolar damage, but other histologic patterns may occasionally be encountered such as acute fibrinous and organizing pneumonia, acute eosinophilic pneumonia, and diffuse hemorrhage with capillaritis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    \u2014To review the diagnostic criteria for various histologic patterns associated with a clinical presentation of acute lung injury and to provide diagnostic aids and discuss the differential diagnosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Data sources.<\/jats:italic>\n                    \u2014The review is drawn from pertinent peer-reviewed literature and the author's personal experience.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    \u2014Acute lung injury remains a significant cause of morbidity and mortality. The pathologist should be aware of histologic patterns of lung disease other than diffuse alveolar damage, which are associated with a clinical presentation of acute lung injury. Identification of these alternative histologic findings, as well as identification of potential etiologic agents, especially infection, may impact patient treatment and disease outcome.\n                  <\/jats:p>","DOI":"10.5858\/134.5.719","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T12:22:38Z","timestamp":1613132558000},"page":"719-727","source":"Crossref","is-referenced-by-count":112,"title":["The Pathologist's Approach to Acute Lung Injury"],"prefix":"10.5858","volume":"134","author":[{"given":"Mary Beth","family":"Beasley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"3, pt 1","key":"i1543-2165-134-5-719-b01","series-title":"Am J Respir Crit Care Med","first-page":"818","article-title":"The American-European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination.","volume":"149","author":"Bernard, G. 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Clinical epidemiology of acute lung injury and acute respiratory distress syndrome: incidence, diagnosis, and outcomes.Clin Chest Med2006. 27 (4):549\u2013557."},{"issue":"7","key":"i1543-2165-134-5-719-b03","series-title":"Am J Respir Crit Care Med","first-page":"798","article-title":"Acute respiratory distress syndrome: a historical perspective.","volume":"172","author":"Bernard, G. R.","year":"2005","unstructured":"Bernard, G. R.\n          \n          Acute respiratory distress syndrome: a historical perspective.\n          Am J Respir Crit Care Med\n          2005. 172 (7):798\u2013806."},{"issue":"16","key":"i1543-2165-134-5-719-b04","series-title":"N Engl J Med","first-page":"1685","article-title":"Incidence and outcomes of acute lung injury.","volume":"353","author":"Rubenfeld, G. D.","unstructured":"Rubenfeld, G. D., E.Caldwell, E.Peabody, et al. 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Diffuse alveolar damage\u2014the role of oxygen, shock, and related factors: a review.Am J Pathol1976. 85 (1):209\u2013228."},{"issue":"4","key":"i1543-2165-134-5-719-b18","series-title":"Semin Respir Crit Care Med","first-page":"350","article-title":"The role of cytokines during the pathogenesis of ventilator-associated and ventilator-induced lung injury.","volume":"27","author":"Belperio, J. A.","year":"2006","unstructured":"Belperio, J. A., M. P.Keane, J. P.LynchIII, and R. M.Strieter. The role of cytokines during the pathogenesis of ventilator-associated and ventilator-induced lung injury.Semin Respir Crit Care Med2006. 27 (4):350\u2013364."},{"issue":"4","key":"i1543-2165-134-5-719-b19","series-title":"Clin Chest Med","first-page":"705","article-title":"Genetic epidemiology of acute respiratory distress syndrome: implications for future prevention and treatment.","volume":"27","author":"Gong, M. N.","year":"2006","unstructured":"Gong, M. N.\n          \n          Genetic epidemiology of acute respiratory distress syndrome: implications for future prevention and treatment.\n          Clin Chest Med\n          2006. 27 (4):705\u2013724."},{"issue":"6","key":"i1543-2165-134-5-719-b20","series-title":"Chest","first-page":"1906","article-title":"Pathogenetic significance of biological markers of ventilator-associated lung injury in experimental and clinical studies.","volume":"130","author":"Frank, J. A.","year":"2006","unstructured":"Frank, J. A., P. E.Parsons, and M. A.Matthay. Pathogenetic significance of biological markers of ventilator-associated lung injury in experimental and clinical studies.Chest2006. 130 (6):1906\u20131914."},{"issue":"3","key":"i1543-2165-134-5-719-b21","series-title":"Clin Chest Med","first-page":"435","article-title":"Pulmonary pathology of acute respiratory distress syndrome.","volume":"21","author":"Tomashefski\n              Jr, J. F.","year":"2000","unstructured":"Tomashefski\n              Jr, J. F.\n          \n          Pulmonary pathology of acute respiratory distress syndrome.\n          Clin Chest Med\n          2000. 21 (3):435\u2013466."},{"issue":"1","key":"i1543-2165-134-5-719-b22","series-title":"Am J Clin Pathol","first-page":"10","article-title":"Regional alveolar damage (RAD): a localized counterpart of diffuse alveolar damage.","volume":"92","author":"Yazdy, A. M.","year":"1989","unstructured":"Yazdy, A. M., J. F.TomashefskiJr, R.Yagan, and J.Kleinerman. Regional alveolar damage (RAD): a localized counterpart of diffuse alveolar damage.Am J Clin Pathol1989. 92 (1):10\u201315."},{"issue":"4","key":"i1543-2165-134-5-719-b23","series-title":"Am J Surg Pathol","first-page":"256","article-title":"Acute interstitial pneumonia: a clinicopathologic, ultrastructural, and cell kinetic study.","volume":"10","author":"Katzenstein, A. L.","year":"1986","unstructured":"Katzenstein, A. L., J. L.Myers, and M. T.Mazur. Acute interstitial pneumonia: a clinicopathologic, ultrastructural, and cell kinetic study.Am J Surg Pathol1986. 10 (4):256\u2013267."},{"issue":"1","key":"i1543-2165-134-5-719-b24","series-title":"Am J Pathol","first-page":"112","article-title":"The pulmonary vascular lesions of the adult respiratory distress syndrome.","volume":"112","author":"Tomashefski\n              Jr, J. F.","year":"1983","unstructured":"Tomashefski\n              Jr, J. F., P.Davies, C.Boggis, R.Greene, W. M.Zapol, and L. M.Reid. The pulmonary vascular lesions of the adult respiratory distress syndrome.Am J Pathol1983. 112 (1):112\u2013126."},{"issue":"9","key":"i1543-2165-134-5-719-b25","series-title":"Intensive Care Med","first-page":"1293","article-title":"Acute lung injury and the coagulation pathway: potential role of gene polymorphisms in the protein C and fibrinolytic pathways.","volume":"32","author":"Sapru, A.","year":"2006","unstructured":"Sapru, A., J. L.Wiemels, J. S.Witte, L. B.Ware, and M. A.Matthay. Acute lung injury and the coagulation pathway: potential role of gene polymorphisms in the protein C and fibrinolytic pathways.Intensive Care Med2006. 32 (9):1293\u20131303."},{"issue":"4","key":"i1543-2165-134-5-719-b26","series-title":"Clin Chest Med","first-page":"593","article-title":"Pulmonary pathology of the adult respiratory distress syndrome.","volume":"11","author":"Tomashefski\n              Jr, J. F.","year":"1990","unstructured":"Tomashefski\n              Jr, J. F.\n          \n          Pulmonary pathology of the adult respiratory distress syndrome.\n          Clin Chest Med\n          1990. 11 (4):593\u2013619."},{"issue":"2","key":"i1543-2165-134-5-719-b27","series-title":"Semin Thorac Cardiovasc Surg","first-page":"62","article-title":"Surgical pathology of pulmonary infections.","volume":"7","author":"Travis, W. D.","year":"1995","unstructured":"Travis, W. 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M.Dwyre, J.Krochmal, and T. J.Raife. Transfusion-related acute lung injury (TRALI): current clinical and pathophysiologic considerations.Lung2006. 184 (3):177\u2013185."},{"issue":"4","key":"i1543-2165-134-5-719-b31","series-title":"Clin Chest Med","first-page":"591","article-title":"Newly recognized causes of acute lung injury: transfusion of blood products, severe acute respiratory syndrome, and avian influenza.","volume":"27","author":"Looney, M. R.","year":"2006","unstructured":"Looney, M. R.\n          \n          Newly recognized causes of acute lung injury: transfusion of blood products, severe acute respiratory syndrome, and avian influenza.\n          Clin Chest Med\n          2006. 27 (4):591\u2013600."},{"issue":"4","key":"i1543-2165-134-5-719-b32","series-title":"Crit Care Med","first-page":"721","article-title":"Transfusion-related acute lung injury: definition and review.","volume":"33","author":"Toy, P.","year":"2005","unstructured":"Toy, P., M. A.Popovsky, E.Abraham, et al. Transfusion-related acute lung injury: definition and review.Crit Care Med2005. 33 (4):721\u2013726."},{"issue":"1","key":"i1543-2165-134-5-719-b33","series-title":"Clin Chest Med","first-page":"105","article-title":"Pulmonary injury from transfusion-related acute lung injury.","volume":"25","author":"Kopko, P. M.","year":"2004","unstructured":"Kopko, P. M. and M. A.Popovsky. Pulmonary injury from transfusion-related acute lung injury.Clin Chest Med2004. 25 (1):105\u2013111."},{"issue":"11","key":"i1543-2165-134-5-719-b34","series-title":"Transfusion","first-page":"2401","article-title":"Pulmonary pathology of rapidly fatal transfusion-related acute lung injury reveals minimal evidence of diffuse alveolar damage or alveolar granulocyte infiltration.","volume":"48","author":"Danielson, C.","year":"2008","unstructured":"Danielson, C., R. J.Benjamin, M. M.Mangano, C. J.Mills, and D. A.Waxman. Pulmonary pathology of rapidly fatal transfusion-related acute lung injury reveals minimal evidence of diffuse alveolar damage or alveolar granulocyte infiltration.Transfusion2008. 48 (11):2401\u20132408."},{"issue":"9","key":"i1543-2165-134-5-719-b35","series-title":"N Engl J Med","first-page":"569","article-title":"Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure.","volume":"321","author":"Allen, J. N.","year":"1989","unstructured":"Allen, J. N., E. R.Pacht, J. E.Gadek, and W. B.Davis. Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure.N Engl J Med1989. 321 (9):569\u2013574."},{"issue":"3","key":"i1543-2165-134-5-719-b36","series-title":"Radiology","first-page":"715","article-title":"Acute eosinophilic pneumonia: radiologic and clinical features.","volume":"203","author":"King, M. A.","year":"1997","unstructured":"King, M. A., A. L.Pope-Harman, J. N.Allen, G. A.Christoforidis, and A. J.Christoforidis. Acute eosinophilic pneumonia: radiologic and clinical features.Radiology1997. 203 (3):715\u2013719."},{"issue":"9","key":"i1543-2165-134-5-719-b37","series-title":"Am J Respir Crit Care Med","first-page":"1235","article-title":"Idiopathic acute eosinophilic pneumonia: a study of 22 patients.","volume":"166","author":"Philit, F.","year":"2002","unstructured":"Philit, F., B.Etienne-Mastroianni, A.Parrot, C.Guerin, D.Robert, and J. F.Cordier. Idiopathic acute eosinophilic pneumonia: a study of 22 patients.Am J Respir Crit Care Med2002. 166 (9):1235\u20131239."},{"issue":"6","key":"i1543-2165-134-5-719-b38","series-title":"Medicine (Baltimore)","first-page":"334","article-title":"Acute eosinophilic pneumonia: a summary of 15 cases and review of the literature.","volume":"75","author":"Pope-Harman, A. L.","year":"1996","unstructured":"Pope-Harman, A. L., W. B.Davis, E. D.Allen, A. J.Christoforidis, and J. N.Allen. 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A case of cigarette smoking-induced acute eosinophilic pneumonia showing tolerance.Chest2000. 117 (1):277\u2013279."},{"issue":"1","key":"i1543-2165-134-5-719-b41","series-title":"N Engl J Med","first-page":"51","article-title":"Eosinophilic reactions in the lung.","volume":"281","author":"Carrington, C. B.","year":"1969","unstructured":"Carrington, C. B.\n          \n          Eosinophilic reactions in the lung.\n          N Engl J Med\n          1969. 281 (1):51."},{"issue":"4","key":"i1543-2165-134-5-719-b42","series-title":"Medicine (Baltimore)","first-page":"251","article-title":"The eosinophilic pneumonias.","volume":"48","author":"Liebow, A. A.","year":"1969","unstructured":"Liebow, A. A. and C. B.Carrington. 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