[Chronic inflammatory processes in the lungs: their intravital pathologicoanatomic diagnosis and prognosis]

Combined morphological study of 714 bronchial biopsies and 363 samples of bronchoalveolar lavage (BAL) from 560 patients with chronic inflammatory diseases of nonspecific and tuberculous etiology was carried out. By light microscopic, electron microscopic and radioautographic investigation it was shown, that more important criteria of the dynamics of pathologic process, the stages of compensatory-adaptive reorganization of the lungs and the prognosis of disease were the structural-metabolic transformation of surface epithelium (metaplasia to stratified squamous epithelium or its atrophy) and the quantitative-qualitative characteristics of alveolar macrophages. A correlation was revealed between metabolic activity of BAL cells and those of bronchial epithelial cells, which determined the structural-functional interaction between the airways and respiratory part of the lungs under chronic inflammatory processes and promoted the right interpretation of clinical and morphological data. Morphological changes mainly of degenerative, but noninflammatory genesis often observed in the last years during chronic inflammatory processes in the lungs, are considered in terms of regenerative-plastic insufficiency of cells and intracellular structures.