PATHOMORPHOLOGY OF EMPHYSEMA COMPLEX .2.

Abstract

With specific reference to pulmonary emphysema, several distinctive patterns exist; their complete portriat awaits further integration of ante mortem functional findings and quantitative pathologic studies. The writers'' histomechanical studies suggest that an informative pattern of airway obstruction and impaired contractility is produced by both centrilobular and panlobular emphysema. This obstructive ventilatory pattern is remarkably similar to that which has been documented during life and, even in early forms of lung emphysema, is of correlative value. Quantitative studies of anatomic emphysema, correlated with deflation-time studies and bronchographic profiles, reinforce the clinical thesis that a single common factor, functional collapse of air-conducting units, is a major determinant in airway obstruction and progression of anatomic emphysema. Chronic bronchitis and emphysema may exist independently of eath other; if coexistent, the chronic bronchitis component will aggravate the clinical findings and obscure the pressure[long dash]or affect the course[long dash]of the anatomic emphysema. Certain pulmonary disabilities long held to be allied with emphysema were found, on morphoanalytic reexamination, to be nondissolutive in nature, and revealed significant information on the problems of hyperinflation, aging of pulmonic tissue, and vascular derangements concerned in cor pulmonale.