DEGENERATION OF CILIATED CELLS OF BRONCHIAL EPITHELIUM (CILIOCYTOPHTHORIA) IN ITS RELATION TO PULMONARY DISEASE

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Abstract
Previous studies have shown that in certain cases of acute and chronic pulmonary diseases there is a mass degeneration of ciliated cells of the bronchial epithelium which can be detected by microscopy of sputum specimens. The present studies have been undertaken for the purpose of exploring further the extent and significance of this phenomenon ("ciliocytophthoria," or "CCP") in two groups of patients: 500 essentially asymptomatic (A), and 500 symptomatic (B). In both groups there was a definite increase in the CCP numerical index in sputum specimens from the chronic cases, and more so in the acute inflammatory cases. The advent of an epidemic of Asian influenza during the period of the A series study resulted in a still greater increase in the CCP readings in a large percentage of sputum specimens, particularly in patients with acute respiratory symptoms, indicating a possible etiologic relationship of this phenomenon to pulmonary infections of viral origin. The relatively higher readings in the patients with primary carcinoma of the lung as compared with those of the combined inflammatory group in series B suggests a relationship of this phenomenon to malignant disease as well. A case is described in which positive CCP findings were followed first by the appearance of metaplastic cells, and later, malignant cells. A subsequent operation proved the existence of an early epidermoid carcinoma of the lung. The mass destruction of ciliated cells in both chronic and acute pulmonary infections is likely to result in the formation of nonciliated areas on the surface of the bronchial mucosa, thus opening the gateway to the action of extraneous carcinogenic and other injurious agents.