SIGNIFICANCE OF MORPHOLOGIC CHRONIC HYPERPLASTIC BRONCHITIS

Publisher Website
Google Scholar
Abstract
The clinical and laboratory findings in 46 consecutive cases of bronchial mucous gland hyperplasia proved by autopsy were reviewed. Chronic cough, expectoration, and repeated deep chest infections were common during life, but were not invariably present. The bronchial lesions were found in 6 patients with no symptoms and in 4 others with very mild symptoms of cough and expectoration or dyspnea or both. Bronchial mucous gland hyperplasia was found in 1 person who did not smoke and in 4 others who were very light cigarette smokers. Persons without mucous gland hyperplasia were less apt to have been regular cigarette smokers. The emphysema accompanying mucous gland hyperplasia varied from none to severe. The relationship of mucous gland hyperplasia to other clinical and pathologic findings was analyzed in 175 consecutive, especially studied, autopsied cases with and without lung disease. The hyperplastic lesion was absent in 30 of 64 cases of clinical chronic bronchitis. In 72 patients with mucous gland hyperplasia or moderate to severe emphysema, or both, only 25 were found in which both lesions were present. The only characteristic and nearly unique clinical manifestation of patients with mucous gland hyperplasia (always in association with at least mild destructive emphysema) was the combination of hypoxia, pulmonary hypertension, right heart failure, and secondary polycythemia, which was observed in 46%. The mechanism for the production of this syn drome in bronchial disease is unclear.