Abstract
A new pathological entity is here described—a polyalveolar lobe with or without emphysema—giving rise to the clinical features of childhood lobar emphysema.
A detailed and quantitative study of the airways, alveoli and arteries was carried out on the left upper lobe removed because of shortness of breath, thought to be due to `childhood lobar emphysema'. The child was 17 days old and the radiograph showed hypertransradiancy of the left lung. The alveolar number was increased five-fold. Alveolar size was normal, so it was found that emphysema, accepted today as a structural diagnosis, was not present. The increase in alveolar number seemed confined to the apical, posterior, and anterior segments, the lingula being unaffected. By contrast, the airways and arteries were normal for age in number, size and structure, suggesting that the condition was a `giantism' of the alveolar region. The blood flow was probably too low for the lobar volume; certainly the excessive alveolar number could not be due to increase in blood flow.
In two further specimens, previously dissected, a similar polyalveolar condition was found, associated with emphysema. The patients were older at the time of surgical resection and the emphysema may have developed post-natally. In all three cases the radiographic features had suggested emphysema. It is suggested that the condition be called `polyalveolar lobe', `with emphysema' or `without emphysema' being added as a separate item to the description.
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- BOLANDE R. B., SCHNEIDER A. F., BOGGS J. D. Infantile lobar emphysema; an etiological concept. AMA Arch Pathol. 1956 Apr;61(4):289–294. [PubMed] [Google Scholar]
- BOYDEN E. A. THE TERMINAL AIR SACS AND THEIR BLOOD SUPPLY IN A 37-DAY INFANT LUNG. Am J Anat. 1965 Mar;116:413–428. doi: 10.1002/aja.1001160207. [DOI] [PubMed] [Google Scholar]
- Boyden E. A., Tompsett D. H. The changing patterns in the developing lungs of infants. Acta Anat (Basel) 1965;61(2):164–192. doi: 10.1159/000142692. [DOI] [PubMed] [Google Scholar]
- Davies G., Reid L. Growth of the alveoli and pulmonary arteries in childhood. Thorax. 1970 Nov;25(6):669–681. doi: 10.1136/thx.25.6.669. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ELLIOTT F. M., REID L. SOME NEW FACTS ABOUT THE PULMONARY ARTERY AND ITS BRANCHING PATTERN. Clin Radiol. 1965 Jul;16:193–198. doi: 10.1016/s0009-9260(65)80042-3. [DOI] [PubMed] [Google Scholar]
- EMERY J. L., MITHAL A. The number of alveoli in the terminal respiratory unit of man during late intrauterine life and childhood. Arch Dis Child. 1960 Dec;35:544–547. doi: 10.1136/adc.35.184.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LEAPE L. L., LONGINO L. A. INFANTILE LOBAR EMPHYSEMA. Pediatrics. 1964 Aug;34:246–255. [PubMed] [Google Scholar]
- SIMON G., REID L. ATRESIA OF AN APICAL BRONCHUS OF THE LEFT UPPER LOBE--REPORT OF THREE CASES. Br J Dis Chest. 1963 Jul;57:126–132. doi: 10.1016/s0366-0850(63)80057-5. [DOI] [PubMed] [Google Scholar]
- STOVIN P. G. Congenital lobar emphysema. Thorax. 1959 Sep;14:254–262. doi: 10.1136/thx.14.3.254. [DOI] [PMC free article] [PubMed] [Google Scholar]
- THOMSON J., FORFAR J. O. Regional obstructive emphysema in infancy. Arch Dis Child. 1958 Apr;33(168):97–108. doi: 10.1136/adc.33.168.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WADDELL J. A., SIMON G., REID L. BRONCHIAL ATRESIA OF THE LEFT UPPER LOBE. Thorax. 1965 May;20:214–218. doi: 10.1136/thx.20.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WEIBEL E. R., GOMEZ D. M. A principle for counting tissue structures on random sections. J Appl Physiol. 1962 Mar;17:343–348. doi: 10.1152/jappl.1962.17.2.343. [DOI] [PubMed] [Google Scholar]