To determine whether pathological changes in the small airways are evenly distributed throughout the lung and whether there is an association of small airway disease with emphysema, pathological abnormalities of the small airways were graded in the upper and lower lobes of 13 surgical lung specimens. Except for slightly increased degrees of respiratory bronchiolar inflammation in the lower lobe, no differences were found between the two sites, nor was there any relationship between the presence of pathological abnormalities in the small airways and the presence of centrilobular emphysema. It is concluded that the predilection of centrilobular emphysema for the upper lung zone is not associated with a difference in intensity of airway disease between upper and lower lobes.
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