THE SITE, SEVERITY, AND DISTRIBUTION OF BRONCHIOLAR OBSTRUCTION IN LUNGS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE - MORPHOMETRY AND COMPUTER-ASSISTED 3-DIMENSIONAL RECONSTRUCTION OF AIRWAYS

Autopsy lungs from 10 patients with various types of chronic obstructi ve pulmonary disease were submitted to morphometry and computer-aided three-dimensional reconstruction of airways to study, by the former te chnique, the severity and the site of obstruction in the bronchioles a nd to visualize, by the latter, how far the whole airway bed was invol ved. The site of obstruction in the bronchioles was shown to be differ ent between diffuse panbronchiolitis and bronchobronchiolitis oblitera ns. There was also a case where the entire bronchiolar tree was mildly but uniformly stenosed with mucous hypersecretion, chronic inflammati on, and fibrosis, a pattern considered to correspond to small airways disease. Thus, the combination of the above techniques proved to be us eful in studying the state of the airway bed in chronic obstructive pu lmonary disease, a task not accessible by the usual microscopic examin ation of a single lung section.