Observations on the Pulmonary Vasculature in a Case of Centrilobular Emphysema with Hemosiderosis

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Abstract
A 31-year-old man with centrilobular emphysema complicated by pulmonary hemosiderosis suffered from cor pulmonale for many years and eventually died from congestive cardiac failure. At autopsy the right ventricle was 13 mm. thick and was three times the normal weight. The pulmonary arterioles showed classical hypertensive changes, but the pulmonary arteries showed no abnormality apart from an insignificant increase in medial thickness. These findings support the view that hypertensive pulmonary vascular disease is not a passive phenomenon due to the effect of increased pressure on vessels but is brought about by active response to stimuli, which were apparently not present in this case.