The site, severity, and distribution of bronchiolar obstruction in lungs with chronic obstructive pulmonary disease. Morphometry and computer-assisted three-dimensional reconstruction of airways.

Autopsy lungs from 10 patients with various types of chronic obstructive pulmonary disease were submitted to morphometry and computer-aided three-dimensional reconstruction of airways to study, by the former technique, the severity and the site of obstruction in the bronchioles and to visualize, by the latter, how far the whole airway bed was involved. The site of obstruction in the bronchioles was shown to be different between diffuse panbronchiolitis and bronchobronchiolitis obliterans. There was also a case where the entire bronchiolar tree was mildly but uniformly stenosed with mucous hypersecretion, chronic inflammation, and fibrosis, a pattern considered to correspond to small airways disease. Thus, the combination of the above techniques proved to be useful in studying the state of the airway bed in chronic obstructive pulmonary disease, a task not accessible by the usual microscopic examination of a single lung section.