INTERRELATIONSHIPS AMONG VARIOUS HISTOLOGIC CHANGES IN BRONCHIAL TUBES + IN LUNG PARENCHYMA

Publisher Website
Google Scholar
Abstract
An analysis is presented of the interrelationships among various histologic changes in the bronchial tubes of 758 men and women and in the lung parenchyma of 1, 340 men who were autopsied. The interrelationships in nonsmokers were found to be different from those in cigarette smokers. In the bronchial tubes of nonsmokers, the occurrence of hyperactive glands is associated with the processes of inflammation and repair. Bronchitis is an appropriate term to describe this condition, as it involves both inflammation and excess secretion of mucus in the tracheobronchial tree. Bronchitis in nonsmokers is not associated with changes in the nuclei of cells in tracheobronchial epithelium or with changes in lung parenchyma. In the bronchial tubes of cigarette smokers, the occurrence of hyperactive glands shows very little association with the processes of inflammation and repair. Therefore, there is a question whether the term bronchitis is appropriate to describe the typical condition of a cigarette smoker with clinical evidence of excess secretion of mucus in the tracheobronchial tree. In cigarette smokers, the occurrence of hyperactive glands is associated with hyperplasia of bronchial epithelium together with cells having atypical nuclei; and these changes in bronchial tubes are mainly associated with changes in lung parenchyma, including fibrosis and rupture of alveolar septa. The findings strongly suggest that atypical cells in tracheobronchial epithelium gradually disappear upon cessation of cigarette smoking, whereas changes in lung parenchyma are arrested but do not regress upon cessation of cigarette smoking.