Chest
Volume 101, Issue 3, March 1992, Pages 793-799
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The Senile Lung: Comparison with Normal and Emphysematous Lungs 1. Structural Aspects

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As part of a study of the structural-functional correlations of excised human lungs obtained at autopsy, the parenchyma and peripheral airways were examined by means of morphometric techniques. Among the 30 lungs characterized by the absence of fibrosis, ten differed from the normal and emphysematous lungs by a homogeneous dilatation of the airspaces, in excess of the dimensions predicted on the basis of age. Study of the standard deviations of the mean linear intercepts showed that the airspace dilatation was more regular than in emphysematous lungs; in addition, there was no clear-cut destruction, as estimated from the number of alveolar attachments. These lungs were characterized in addition by an increased thickening of alveolar septa, without inflammation or fibrosis, normal size of the diameter, and reduced density of the membranous bronchioles. Since these lungs were from people older than 60 years, it is assumed that they represent cases of exaggerated airspace enlargement of the aging lung, differing from emphysema by the absence of destruction of alveolar walls. The term “senile lung” is proposed for this condition.

Section snippets

MATERIAL AND METHODS

Studies were performed on 17 right and 12 left human lungs and one isolated left lower lobe (V50), obtained at autopsy. Lungs were selected on the basis of absence of marked pleural adhesions and leaks, gross parenchymal consolidations, and/or generalized fibrosis. Most lungs were from patients who died of cardiovascular disease or of malignant neoplasms. The examined lungs represent a sample that can be considered unselected at least from the population of patients for whom an autopsy was

RESULTS

The lungs were divided into three groups on the basis of the global aspect of the parenchyma on the whole lung sections (examined by eye and under the dissection microscope) and of the value of Lm. Lungs of group A had a normal aspect, the value of Lm did not exceed 120 percent of expected. In the lungs of groups B and C, the value of Lm was higher than 120 percent. The enlargement of the respiratory airspaces was homogeneous in group B, irregular in C. Morphologically the lungs of group C were

DISCUSSION

The use of morphometric techniques allowed us to delineate an anatomic entity of lungs characterized by an exaggerated but homogeneous enlargement of airspaces without destruction (group B), distinct on the one hand from normal (group A), and on the other hand from emphysematous lungs (group C).

The estimation of the enlargement of the airspaces was achieved on the basis of the mean linear intercept, Lm, the uniformity of the airspaces by comparing Lm in upper and lower lobes and by computing

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