Histometry and three-dimensional image reconstruction of the lung in congenital diaphragmatic hernia

A small lung capacity, hypoplasia of the airway system, and abnormalities of the pulmonary artery system have been demonstrated as pathologic characteristics of congenital diaphragmatic hernia, but opinions have differed on the degree of hypoplasia of the acinus and terminal airspace. In this study, acinar size, mean wall thickness of the terminal airspace, an surface area of the terminal airspace were histometrically evaluated in four clinical cases. In addition, the pulmonary artery system was investigated by computerized three dimensional image reconstruction. Hypoplasia of the lung acinus and terminal airspace was observed in all four cases, and hypoplasia was more marked as lung capacity decreased. Thickening of the walls of pulmonary arterioles was confirmed, and previously undescribed abnormal branching of the pulmonary artery was recorded.