Chest
Miscellaneous: Clinical InvestigationsImportance of Diffuse Aspiration Bronchiolitis Caused by Chronic Occult Aspiration in the Elderly
Section snippets
MATERIALS AND METHODS
A retrospective study was performed on 3,253 consecutive autopsy cases at Tokyo Metropolitan Geriatrics Center Hospital (TGH) between November 1985 and December 1992 and on 1, 627 consecutive autopsy cases at the Tokyo University Hospital (TUH) between March 1986 and June 1991. Pathologists examined autopsy cases macroscopically and histologically for characteristics of DAB. Histologic examination was performed on one or two tissue samples in each lobe of both right and left lungs (apical
RESULTS
Aspiration pneumonia (APN) was found in 6.7% of all autopsy cases from the TGH and in 1.0% of all autopsy cases from the TUH. DAB was found in 0.6% and 0.7% of all autopsy cases (age, 81.2±6.2 years [n=20] and 62.6±10.4 years [n=11] [mean±SD]) from the TGH and TUH, respectively. The incidence of DAB in a total of 4, 880 autopsy cases was 0.64% (total, n=31: male, n=21; female, n=10). The distribution of the age of onset of DAB was as follows: age 40 to 49 years, 2 patients; age 50 to 59 years,
DISCUSSION
Aspiration of gastric contents containing food particles can cause varied lesions in the lung. Thus, the term “aspiration pulmonary disease” has been applied to a variety of pulmonary conditions with diverse manifestations. Aspiration pulmonary disease, including aspiration pneumonia, Mendelson's syndrome, and aspiration bronchiolitis, follows the inhalation of gastric contents or infected material from the oropharyngeal region. 4 Chronic aspiration has been reported as a cause of obliterative
ACKNOWLEDGMENTS
We thank Drs. K. Ohtubo and I. Ezaki for their valuable support in pathologic examination, Drs. H. Katayama and C-Y. Shu for their assistance, and T. Hamada for his statistical advice. We also thank Drs. S. Hayashi and T. Nagase for their helpful review.
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