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Lobar consolidation

Dr Craig Hacking ◉ ◈ et al.

Lobar consolidation is the term used to describe consolidation in one of the lobes of the lung. It infers a alveolar spead of disease and is most commonly due to pneumonia.

On this page:

Article:

Pathology
Radiographic features
Differential diagnosis
Related articles
References

Pathology

Consolidation refers to the alveolar airspaces being filled with fluid (exudate/transudate/blood), cells (inflammatory), tissue, or other material.

The list of causes of consolidation is broad but for complete consolidation of a lobe the most common cause is pneumonia. Infection spreads through the lobar through the pores of Kohn between alveoli but is limited from spreading between lobes by the visceral pleura.

Other causes include:

pulmonary malignancy
- adenocarcinoma
- lymphoma
bronchial obstruction with no (or minimal collapse)
- endobronchial neoplasm
- bronchial stricture
- foreign body
- extrinsic compression from lymph nodes
pulmonary hemorrhage

Radiographic features

General features of consolidation on CXR include:

airspace opacification causing obscuration of pulmonary vessels
air bronchograms

Specific lobar consolidation can be determined by the location of airspace opacification, pattern and the effect on adjacent structures (silhouette sign):

It must be remembered that the homogeneity of the consolidation will be influenced by any underlying lung disease.

Occasionally with complete lobar consolidation, there may be an increased volume of the affected lobe, rather than the more frequent collapse. When the fissures are outwardly convex, the appearance is referred to as the bulging fissure sign.

A mnemonic to remember the general features of consolidation is A2BC3.

Differential diagnosis

lobar collapse can be mistaken for lobar consolidation but collapse will show signs of volume loss and usually absence of air bronchograms

References

Airspace opacification

Article information

rID: 66160

System: Chest

Section: Gamuts

Synonyms or Alternate Spellings:

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