Alteration of human lung parenchyma associated with primary biliary cirrhosis

The clinical history, radiological and histomorphological alterations of the lung parenchyma in a patient suffering from primary biliary cirrhosis are described. The 70-year-old woman had developed a primary biliary cirrhosis, verified by serological abnormalities (AMA positivity, elevated IgM levels) and by liver biopsy. The lung parenchyma displayed immature epithelioid granulomas and characteristics of a chronic organizing pneumonia. Lung function revealed moderate restrictive changes; chest radiographs revealed bilateral, diffuse, patchy infiltrates in the basal lobes. Application of immunohistology detected antigens in liver cells reactive with anti-IgD and anti-IgG, in pneumocytes those reactive with anti-IgD. Presence of macrophage migration inhibitory factor (MIF) by application of its antibody and of the ligand sarcolectin as well as expression of binding capacities to MIF could not be demonstrated in the liver and lung parenchyma. Neoglycoproteins exposing fucose, N-acetyl-D-glucosamine, lactose and mannose residues did not bind to both the liver and lung tissue. The data indicate that at least some patients with primary biliary cirrhosis may develop or suffer from immunological abnormalities, affecting the lung.