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Scanning electronmicroscopic morphometry of emphysema in humans
1Department of Pathology, Faculty of Medicine, University of British Columbia, Vancouver.
American Journal of Respiratory and Critical Care Medicine
|November 1, 1994
Summary
Alveolar holes in emphysema correlate with lung function. The tissue surrounding emphysematous lesions contributes to the loss of lung recoil, impacting pulmonary function tests.
Area of Science:
- Pulmonary Medicine
- Pathology
- Respiratory Physiology
Background:
- Emphysema is characterized by alveolar wall destruction.
- The role of surrounding tissue in emphysema progression is not fully understood.
Purpose of the Study:
- To quantitate alveolar holes in nonemphysematous and mild emphysematous lungs.
- To correlate alveolar hole characteristics with pulmonary function tests.
Main Methods:
- Surgical lung tissue samples from 11 nonemphysematous and 11 mild emphysematous lungs were analyzed.
- Alveolar hole size, number, and area were measured.
- Correlations between alveolar hole metrics and pulmonary function tests were assessed.
Main Results:
- Nonemphysematous lungs predominantly had small alveolar holes (<10 microns).
- Emphysematous lungs showed increased alveolar hole size and number in parenchyma adjacent to lesions.
- Alveolar holes in regions between emphysema correlated better with pulmonary function tests than those distant from emphysema.
- Specific correlations were found between hole diameter/number and functional residual capacity, residual volume, closing capacity (CC/TLC), and static recoil pressure.
- Emphysema severity correlated with CC/TLC and transpulmonary pressure at 90% TLC.
Conclusions:
- The tissue surrounding emphysematous lesions plays a significant role in the loss of lung recoil.
- Alveolar hole characteristics in regions between emphysema are more indicative of functional impairment than those in distant regions.