Quantitative Study of Parenchyma and Small Conductive Airways in Chronic Nonspecific Lung Disease

Use of Histologic Stereology and Bronchial Casts

¹ Laboratoire d'Histologie et Cytologie pulmonaire, Clinique de Pneumo-Phtisiologie, Hôpital Laënnec, Paris, France

Simultaneous morphometric studies of parenchymal loss and of internal diameters of membranous bronchioles were carried out at autopsy in 42 cases of chronic nonspecific lung disease. In a few cases, a bronchial cast of the right lung was made according to the slightly modified Tompsett's method with the use of resin. The quantitative data were assessed in four anatomic groups: panlobular emphysema, centrilobular emphysema, minimal emphysema, miscellaneous emphysema and were correlated to the right ventricular weight. Inflammatory bronchiolar stenoses were observed in most cases with centrilobular emphysema and with minimal emphysema as shown by the percentage of small airways less than 350_µ in diameter. The degree of right ventricular hypertrophy appeared to correlate more with bronchiolar stenosis than with parenchymal loss. In panlobular emphysema without bronchitis or bronchiolitis or both and without right ventricular hypertrophy, bronchiolar diameters were in normal ranges. The bronchial casts of two patients with moderate emphysema and minimal respiratory failure showed disseminated small airways stenoses of which the site, the shape and the number have been assessed.