The role of bronchoscopy in the study of extrinsic pulmonary granulomatoses

As the bronchial mucous membrane is one of the chief barriers against aggression to the respiratory tract by inhaled particles, the AA. reviewed 68 patients with pulmonary granulomatoses studied at the Department of Chest Diseases, Lisbon University Hospital, that had been submitted to bronchoscopy. Only about 22% of these had normal appearing mucosa, while the rest, among other aspects, showed congestion and edema. Bronchial biopsies were taken in the majority of patients (44). Only in two cases was the mucosa considered histologically normal while granulomas were found in 36% and generally it was possible to identify the nature of the foreign particles inhaled. Analysing the results, the AA. conclude that organic particles seem to produce granulomatous reactions more frequently, while inorganic particles seem rather to produce a marked irritating effect. The frequency with which bronchial changes were found in these patients seems to warrant the conclusions that bronchoscopy plays an important role in the study of patients with extrinsic pulmonary granulomatoses.