RESPIRATORY BRONCHIOLITIS IN SMOKERS WITH SPONTANEOUS PNEUMOTHORAX

Respiratory bronchiolitis (RB) is defined by the accumulation of pigme nted macrophages in the lumen and wall of respiratory and membranous b ronchioles of smokers. The aim of this study was to determine whether spontaneous pneumothorax was associated with a high prevalence of RE. Seventy-nine consecutive patients who underwent a surgical procedure ( thoracotomy or thoracoscopy) for recurrence or persistence of primary spontaneous pneumothorax despite thoracic drainage were studied retros pectively. RB was found in 70 of 79 (88.6%) smokers operated for spont aneous pneumothorax, Associated interstitial pathological abnormalitie s were present in 53 of 79 cases (67.1%). In nine patients, the pathol ogical lesions were severe and resembled desquamative interstitial pne umonia, Emphysematous lesions were present in about one-third of the p atients. Although the possible pathophysiological consequences of resp iratory bronchiolitis remain speculative, this study demonstrates the high prevalence of this pathological abnormality in patients with pneu mothorax requiring surgical treatment.