Bullous emphysema of the lung (honeycomb lung, human, adult)

Macroscopy of the left lung showing large apical bullae (3) due to total destruction of all alveoli leaving remnants of the covering pleura. (2) indicates small bullae of foci of destroyed lobules with permanent enlargement of the air spaces and (1) points to spots of anthracosis in less-affected lung lobules. Synonyms for the disease are idiopathic interstitial fibrosis, fibrosing alveolitis, honeycomb lung, and Hamman-Rich Syndrome. The disease starts with a chronic interstitial pneumonia followed by interstitial fibrosis leading eventually to retraction of the connective tissue causing rupture of the alveolar structures with the formation of multiple cyst-like spaces. The result is a serious emphysema with the formation of large thin-walled bullae.