Tuberc Respir Dis.  1990 Jun;37(2):175-182. 10.4046/trd.1990.37.2.175.

Pathologic Analysis of Pulmonary Interstitial Fibrosis

Abstract

Histopathologic analysis has been conducted on 36 cases of interstitial fibrosis of the lung. The key findings of histologic criteria of interstitial fibrosis are alveolar narrowing and desquamation of epithelial cells in the alveoli, and alveolar septal inflammation, septal fibrosis and honeycombing in the interstitium. In the early stage, the loose fibrillar collagen fibers accumulated irregularly surrounding bronchioles and small vessels with extension to alveolar interstitium. As the lesion advanced, fibrillar fibers gathered in the interstitium with nodular form. Alveolar narrowing, partly hyaline change of vessels or thick bundles of interstitial fibers were noted. In the late stage, diagnostic findings were irregular collagen bundles with smooth muscle hypertrophy in the interstitium, hyper. trophy of the arteriolar wall and especially cystic or honeycomb appearance of alveoli. The problem of transbronchial fiberoptic lung biopsy is so small in size of speicmen that it cannot represent the lesion of inhomogeneous interstitial lung disease. In advanced disease and observation of alvear epithelial changes, the transbronchial fiberoptic lung biopsy is useful. However, the open lung biopsy is more useful to make a diagnosis of early disease with activity.

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