후천성 심층모변막질환에 있어 폐장병변에 관한 병리조직학적 고찰
Histopathologic Study on Pulmonary Changes in Mitral Heart Disease

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dc.identifier.citationSeoul J Med 1982;23(1):59-66en
dc.description.abstractThe progressive morphologic changes of the lung
is known to result from hemodynamic circulatory
disturbance which is expressed as pulmonary hypertension
in acquired mitral stenosis. The changes imply
pulmonary parenchyme and interstitum as well as
pulmonary vasculature. These secondary morphologic
alterations of the lung give great help in understanding
of pathology of pulmonary circulation, and
evaluation for the postoperative prognosis of mitral
heart disease.
\Vith acquired mitral heart disease, which would
be a representative in secondary pulmonary hypertension,
many studies and efforts to present the quantitative
description for alteration of pulmonary artery
have made to raise the necessity of other morphologic
evidence than the vascular changes.
A histomorphologic investigation of lung biopsies
was performed with 56 mitral heart disease from
1971 to 1980, at the Department of Pathology,
College of Medicine, Seoul National University, for
the evaluation of vascular changes according to the
Heath & Edwards classification, and morphologic
changes of bronchus. pleura, alveolar interstitium
and contents in alveolar spaces.
Bronchial changes comprised peribronchial muscular
hypertrophy (63.190), inflammatory cell infiltration
(42.196), fibrosis (31. G90), cellular exudate (26.196)
and squamous metaplasia of bronchial epithelium
(22.296), while pleura showed vascular congestion
(58.890), edema (45.190), fibrosis (31. 496), lymphatic
dilatation (23.590) and mesothelial hyperplasia
(11.196). Hemosiderin laden macrophages were most common (96.4%) intraalveolar contents followed by
hemorrhage (63.6%), and fibrinous exudate (20.0%).
In cases, alveolar spaces contained organizing fibreblastic
proliferation. As with the alveolar interstitium,
most (94.6%) demonstrated capillary congestion,
otherwise, edema (55.4%), endothelial hyperplasia
(48.296), fibrosis (25.0%) and diffuse muscular
hypertrophy (7.196) were observed.
With these changes in alveolar interstitium, a
morphologic staging system was made as follows,
Stage I: capillary congestion without any other
structural change, Stage n: diffuse alveolar septal
thickening with interstitial edema and/or endothelial
hyperplasia, Stage m: mild structural changes with
fibrosis and collagen lay-down which is originally
unidentifible in alveolar septum, Stage N: moderate
effacement of alveolar structure by extended fibrosis
and hypertrophy of smooth muscle, and Stage V:
marked effacement and reconstruction of respiratory
structure where remaining alveolar septum could be
hardly found. The staging system showed fair correlation
with arterial changes according to the Heath
& Edwards classification and pulmonary wedge
Therefore, the staging on the changes of alveolar
interstitium would be proposed, together with gradings
in pulmonary arterial changes (Heath & Edwards
classification), as the morphologic basis for the
evaluation of prognosis in postoperative mitral heart
dc.publisher서울대학교 의과대학en
dc.title후천성 심층모변막질환에 있어 폐장병변에 관한 병리조직학적 고찰en
dc.title.alternativeHistopathologic Study on Pulmonary Changes in Mitral Heart Diseaseen
dc.typeSNU Journalen
dc.contributor.AlternativeAuthorLee, Yoon Seong-
dc.contributor.AlternativeAuthorHam, Eui Keun-
dc.citation.journaltitle서울 의대 잡지 = 서울 의대 학술지 = Seoul Journal of Medicine-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 23 No.1 (1982)
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