Macroscopy: Labelled "Left native lung". Left lung weighing 530 g measuring 218 x 182 x 102 mm. Pleura appears grey/pale tan with a smooth texture. Bronchovascular resection margins are clear with prominent atheroma of vessels. On sectioning, parenchyma appears pale tan with patches of brown scattered throughout both lobes. The vessels are prominent with mildly thickened walls, however, no thrombi are identified. The texture is spongy. No lesions are identified. Hilar lymph nodes appear brown.
Labelled "Right native lung". Right lung weighing 718 g measuring 211 x 194 x 112 mm. Pleura appears grey/pale tan with a smooth texture. Bronchovascular resection margins are clear with prominent atheroma of vessels. On sectioning, parenchyma appears pale tan with patches of brown scattered throughout both lobes. The vessels are prominent with mildly thickened walls, however — no no thrombi are identified. Texture is spongy. No lesions are identified. Hilar lymph nodes appear brown.
Microscopy: Sections of lung, show fibrosis of lung sector with veins and venules within the septa, showing varying degrees of hyalinisation and focal arterialisation. Within the adjacent parenchyma, small arterioles and large arterioles, show myointimal thickening. There are focal areas within the lung within which there is interstitial fibrosis with haemosiderin macrophage. The main pulmonary artery shows severe atherosclerosis. Pulmonary capillary haemangioblastosis is not seen. Pulmonary thromboemboli is not seen.
The patchy interstitial fibrosis seen throughout the lung may related to past radiotherapy.
Diagnostic Opinion: Left and Right native lung showing pulmonary venoocclusive disease, in the setting of patchy interstitial fibrosis.