Selective alveolo-bronchographic findings in type B chronic obstructive lung disease patients with particular...

Selective alveolo-bronchography (SAB) was performed in 14 patients with type B chronic obstructive lung disease to evaluate the morphologic changes of their "small airways". The distance from the branching portion of the segmental bronchus (B9) to the end of the conducting airway was divided into three equal parts (central, middle and peripheral). In the peripheral part, interruption of the airway with a rounded or tapering end was noted at a high incidence (9 cases). Dilatation of the bronchus, irregular outline of the bronchial wall and increased angle of branching were also conspicuous in this part. Inadequate lateral branchings of airways were often observed in the middle and the peripheral part, particularly in the latter (10 cases). Generalized narrowing of an airway and narrowing especially at a branching point were observed in about one half of the cases. Fringes and/or spikes were most often seen in the central part of the airway (9 cases). These pathological appearances are considered to reflect morphologic changes in "small airway disease", and thus SAB can serve as a useful method for detecting lesions of the small airways.