PMC4608164_01
Photomicrography of the lungs (first sibling). A - Lobular simplification (H&E, 50X); B - Immaturity (H&E, 100X); C - Dilated subpleural lymphatics (*) (H&E, 100X); D - Thin-walled vein (white arrow) anomalously positioned adjacent to a muscular pulmonary artery (black arrow) close to the airway (bronchioles [arrowhead]) in the bronchovascular bundle (H&E, 400X).
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Some areas showed anomalous pulmonary veins accompanying pulmonary arteries and bronchi (misaligned pulmonary veins) together with mild lymphatic dilatation (Figure 1).
Photomicrography of the lungs (first sibling). A - Thickened alveolar septae with poor capillary bed and a thickened arteriole (H&E, 400X); B - Extension of smooth muscle into intracinar small arteries (arrowheads) (H&E, 400X); C - Small alveoli with a reduced capillary bed (H&E, 400X); D - Focal alveolar damage with hyaline membrane and alveolar hemorrhage (H&E, 400X).
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Focal thrombi in pulmonary branches were seen, as well as foci of alveolar damage with hyaline membranes and alveolar hemorrhage (Figure 2).
Photomicrography of the lungs (second sibling). A - Misalignement of thin-walled veins anomalously positioned within the same adeventitia of the adjacent to a muscular pulmonary artery close to the airway (H&E, 200X); B - Muscularization of intracinar small artery (H&E, 400X); C - Malpositioning of thin-walled veins adjacent to a thickened pulmonary artery (H&E, 400x); D - Focal alveolar damage with hyaline membrane (H&E, 400X).
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A few bronchial arteries were very thickened and foci of alveolar damage with hyaline membranes and alveolar hemorrhage were found as well (Figure 3).