[The diagnosis of chronic dust-induced bronchitis]

In dust-induced bronchitis, alterations in the pulmonary parenchyma present themselves in the main cellular indices for bronchioalveolar lavage (BAL), thought to be of much importance to its diagnosis. A total of 53 patients with initial and manifest forms of dust bronchitis underwent BAL. There has been found the following: a decrease in the mononuclear phagocyte system cells (MPhS) reflecting the state of local cellular immunity; rise in the amounts of coniophages, suggesting phagocytic activity of alveolar macrophages (AM) and dust blockade of MPhS cells; emergence and augmentation of counts of gigantic Pirogov-Langhans' cells characteristic of tuberculous granulomas, and also decrease in the counts of lymphocytes. There is a striking decrement in the vitality of AM, with polycytosis being commonly seen. Detection of granular forms of Mycobacterium tuberculosis in BAL and Pirogov-Langhans' cells enables a major proportion of "dust-induced bronchitis" to be considered as belonging to the silicotuberculous process.