Abstract
Cases which have cough and sputum continuing one to three months for two years or more and have no specific disease, were divided into two groups, one which shows diffuse small-nodular shadows on chest radiogram and others which do not. The former was defined as diffuse panbronchiolitis (DPB) and the latter, “chronic bronchitis (CB)”. Clinical and pathological findings were compared between these two groups.
1) Clinical symptoms were more severe, lung function was more deteriorated, prognosis was poorer and the coincidence rate of chronic sinusitis was higher in the DPB group than in the CB group.
2) X-ray findings showed the above-mentioned specific pattern in the DPB group, while the CP group showed increased lung markings, asymmetricall distributed fibrous shadows or pleural adhesion.
3) Grossly, the DPB group showed diffusely disseminated yellowishh patchy lesions and bronchioloectasis, while the CB group demonstrated fibrous thickening of peribronchial connective tissue, interlobular septum or interlobar pleura as well as bullae or emphysema in vasying degrees.
4) Hypertrophy of bronchial glands, estimated by Reid's index, was similarly prominent in both groups.
5) Cellular infiltration in the bronchial wall (2nd order) as well as in the bronchiolar one were more prominent in the DPB group than in the CB group and there was peribronchiolar intraalveolar cell infitration in the former which was not seen in the latter.
6) Fibrous thickening of the peribronchiloar connective tissue, alveolar septal fibrosis, lymphoid tissue formation and emphysema were minimal in the DPB group, while these are frequently seen in vasying degrees in the CB group. Though theses observations were limited to autopsy cases showing advanced and complicated findings, it seems that there is no quantative difference in histopathological findings between these two groups. Whereas the DPB group showed more severe and active inflammatory changes and the CB group showed slighter and more chronic reparative processes, both groups appear to fall in the same disease categoryffecting from the nasal cavity to respiratory bronchioles. Qualitative difference causing some characteristic clinical and pathological findings of DPB may be based on the especially low resistance of airways to the infection. Further studies are required on the exogenous factors acting at the onset of disease, pathological findings of the early stage and on the factors prolonging the bronchial infection.
