What is the condition that does NOT occur in lung consolidation?

There are many types of lung diseases, and the situation is quite complex. Pulmonary consolidation refers to the disappearance of gas within the lungs due to atelectasis and alveolar effusion, resulting in substantial changes in lung tissue. There are many factors that can lead to pulmonary consolidation, commonly including excessive secretion of airway mucosal epithelium, increased leakage of capillary serum, and aspiration of fluids. The specific condition requires further examination for diagnosis. So, what kind of situation does not occur in pulmonary consolidation? Let's take a look below.

Firstly, pulmonary consolidation does not occur in the absence of gas within the lungs due to atelectasis and alveolar effusion, resulting in substantial changes in lung tissue. A large amount of exudate fills the alveolar cavity, reducing or eliminating the gas within the cavity, and the lung tissue becomes firm like the liver, known as consolidation. This is most commonly seen in pneumococcal pneumonia. In the early stages of the lesion, the respiratory sounds decrease, tactile fremitus increases, and percussion produces a dull sound. As the consolidation progresses to a large area, tactile fremitus becomes significantly enhanced, percussion produces both a dull and a solid sound, and bronchial breathing sounds and vesicular sounds can be heard.

There are many causes of pulmonary consolidation, and the sources of the fluid that causes it are mainly three types: excessive secretion of airway mucosal epithelium, which is mainly seen in infections caused by bacteria, viruses, and fungi; increased leakage of capillary serum, which is seen in pulmonary edema due to increased venous pressure in left heart failure, with edema spreading gradually from the hilum of the lung towards the periphery in a butterfly-shaped distribution; and aspiration of fluids, which can be caused by drowning or accidental inhalation of vomit into the lungs.

Secondly, examination of pulmonary consolidation includes:

(1) Morphology and echogenicity: The morphology and echogenicity of consolidated lungs vary depending on the cause. Obstructive pulmonary consolidation (atelectasis) is often accompanied by pleural effusion and is mostly echogenic, with a morphology similar to the corresponding lung lobe or segment. Inflammatory exudative pulmonary consolidation is mostly hypoechoic or isoechoic, and its morphology can be irregular.

(2) Air- or fluid-containing tubular structures: The presence of air- or fluid-containing tubular structures arranged in a branched pattern within the consolidated lung is the most important feature for the two-dimensional ultrasonic diagnosis of pulmonary consolidation.

(3) Blood flow signals and blood flow spectrum: The lungs are one of the organs with rich blood supply, and blood circulation still exists in the consolidated lung. Detection of blood flow signals by ultrasound is a sensitive and reliable basis for color Doppler ultrasound to distinguish pulmonary consolidation from pleural effusion.

(4) Internal masses: Ultrasonic detection of mass-like structures within the consolidated lung is of great value for the etiological diagnosis of pulmonary consolidation. Literature reports indicate that color Doppler ultrasound has high value in determining the benign or malignant nature of space-occupying lesions, and can even be comparable to CT examination.