Ohata M, Suzuki H
Chest. 1980 Jun;77(6):771-6. doi: 10.1378/chest.77.6.771.
We have performed 253 thoracotomies among a total of 334 cases of spontaneous pneumothorax during the past 17 years, subjecting 126 of these surgical cases to histologic examination by light microscope. Recently, we have classified 54 emphysematous bullae as Reid type 1 or 2 and have examined these, as well as giant bullae, by scanning electron microscope. This revealed exterior surface differences among the three types of cysts: type 1 exhibits a marked absence of mesothelial cells, whereas type 2 and giant bulla do not. At the bases of bullae, deteriorated pulmonary parenchyma, exposed to alveolar space, shows reticulated trabecula-like structures. Our study supports the possibility of air leaking through the wall of the bulla into the pleural cavity at a certain level of pressure, thus emphasizing the role of pleural mesothelial cells in the genesis of spontaneous pneumothorax.
在过去17年里，我们共对334例自发性气胸患者实施了253例开胸手术，其中126例手术病例接受了光镜组织学检查。最近，我们将54个肺大疱分为Reid 1型或2型，并通过扫描电子显微镜对这些肺大疱以及巨大肺大疱进行了检查。结果显示，这三种类型的囊肿外表面存在差异：1型囊肿明显缺乏间皮细胞，而2型囊肿和巨大肺大疱则没有。在肺大疱底部，暴露于肺泡腔的肺实质恶化，呈现出网状小梁样结构。我们的研究支持在一定压力水平下，空气可能通过肺大疱壁漏入胸腔的可能性，从而强调了胸膜间皮细胞在自发性气胸发生过程中的作用。
