Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
History
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
Microscopic examination shows that the patches of dense fibrous
tissue seen at autopsy almost invariably surround dilated bronchi
with no cartilage in their walls (Fig. 28) and with a diameter of
from 1 to 2 or more millimeters. These bronchi have lost their
epithelial lining; they contain polynuclear leucocytes, and their
wall in contact with the lumen is infiltrated to a varying distance
with the same cells. Their inner surface is very irregular, and
superficial necrosis occurs. The limits of the preexisting bronchial
wall is no longer recognizable in the dense surrounding fibrous
tissue richly infiltrated with lymphoid and plasma cells. In contact
with the bronchus, often in a wide zone, all traces of alveoli have
been destroyed, but further outward alveoli are represented by
spaces lined by cubical epithelium. At the periphery of the zone of
fibroid induration alveolar walls are much thickened and richly
infiltrated with mononuclear wandering cells; the lumina of the
alveoli contain plugs of organized fibrous tissue often covered by
flat or cubical epithelium. In the surrounding tissue a few small
bronchi are lined by columnar epithelium; there is scant new
formation of fibrous tissue but the alveolar walls are thickened and
infiltrated with cells. Epithelium of the larger bronchi with
cartilage in their walls is usually intact and there is about them
little peribronchial inflammation.
Advanced induration about the bronchioles represents a late stage of
chronic peribronchiolar pneumonia. A bronchiole cut transversely is
found in the center of a focus of induration situated within relatively
normal air containing lung tissue. Next the bronchiole which in some
instances has wholly or partly lost its epithelium there is very
cellular fibrous tissue; further from the bronchiole alveoli are much
diminished in size, lined by flat or cubical epithelium and separated by
thick cellular walls. Plugs of cellular fibrous tissue sometimes fill
the alveolar duct. In favorable sections, cut in a plane which shows the
alveolar duct opening out into infundibula, it is found that newly
formed fibrous tissue surrounds the alveolar duct and extends into the
walls of its tributary alveoli; alveoli may be obliterated by this
fibrous tissue. Induration of alveolar walls is evident along the
proximal part of the infundibula which are readily demonstrable because
they are much dilated. (See Fig. 32.) The distal parts of the
infundibula are surrounded by alveoli with delicate walls.
One bronchus retains along one side part of its epithelium which has
assumed a squamous form. In other places the wall has undergone necrosis
which at one spot extends deeply into the surrounding tissue. Necrotic
tissue in another part of the circumference is infiltrated with
polynuclear leucocytes and separated from the surrounding tissue by a
space filled with leucocytes. An abscess communicating with the bronchus
is thus formed.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account