[Diabetic macro- and microangiopathy of the lungs].

Results of histologic, immunohistochemical and ultrastructural examination of pulmonary vessels of 85 necropsy cases (65 patients had diabetes and 20 were controls with atherosclerosis). In the lung vessels in diabetes the changes in the arteries of the elastomuscular and muscular types were frequently found (73.8 and 81.5%, respectively) which were regarded as manifestations of diabetic macroangiopathy, as well as those of arterioles, capillaries (81.5 and 55.4%, respectively) which are the expression of diabetic macroangiopathy. Macroangiopathy is represented by thickening of the endothelial basal membrane, destruction of the internal elastic lamina, its mucoid edema. An extreme manifestation is lipogranulomatosis of the arteries of muscle type. These changes are frequently associated with arterial thrombosis. Diabetic microangiopathy is characterized by plasmorrhagy and hyalinosis of the wall (lipohyaline) with the development of the nodular arteriolo-hyalinosis, the thickening of the endothelial basal membrane and frequent necrosis of capillary pericytes. A specific feature of the diabetic angiopathy is lipidosis of all cells in the lung artery system and its extracellular structures combined with lipidosis of type II pneumocytes producing surfactant and phagocyting alveolar macrophages and polinuclear leukocytes.