Clinicopathological Studies of Bronchial Asthma : 2.Pathological Research in Cases of Death from Asthma

Abstract

Pathological finding in 27 autopsy cases of bronchial asthma and 4 cases changed into emphysema were investigated. The pathological findings in the asthma lungs were as follows: 1) Broncho-constriction (hypertrophy of smooth muscle, fold-like prominence of mucous membrane, and narrowing of lumina), 2) mucous hypersecretion (hypertrophy of mucous gland and goblet cell-like formation of bronchial epithelium), 3) cellular response of bronchial wall (infiltration of eosinophil, plasma cells, lymphocytes, and decrease in number and degranulation of mast cell), 4) edema and thickening of bronchial wall, 5) thickening of basement membrane, 6) distended lungs. The real pathological manifestation was shown by 1) and 2) above mentioned, and the pathological triad of 1), 2) and 3) was decided. These findings were most complete and prominent in the cases of death during attack, especially suffocation. When emphysema was dominant, hypertrophy of the right heart was found. The adrenal atrophy was dominant in order of the severity of asthma, the hypofunction of adrenal cortex, and the amount of steroids administered. The adrenal atrophy was most prominent in severe chronic asthma (intractable asthma).