A pathological study on fibrosis in autopsied lungs with pulmonary sarcoidosis
Takemura, T.; Akiyama, O.; Oritsu, M.; Matsui, Y.; Fukayama, M.; Koike, M.; Uetake, K.; Kudo, S.; Yotsumoto, H.; Mikami, R.
Nihon Kyobu Shikkan Gakkai Zasshi 26(4): 386-393
1988
ISSN/ISBN: 0301-1542 PMID: 3221577 Document Number: 313304
The pattern, distribution, and process of fibrosis in four autopsied lungs from patients with pulmonary sarcoidosis were examined histologically and ultrastructurally. Most of the fibrotic lesions were derived from solitary or confluent granulomas, showing hyalinized nodules, focal patchy fibrosis, and band-like fibrosis. There was also fibrosing alveolitis, not derived from granuloma. The most frequent fibrosis was focal, patchy fibrosis, seen around bronchi, bronchioli, pulmonary arteries, and pulmonary parenchyma. Marked fibrosis was seen around segmental bronchi and pulmonary arteries with luminal narrowing of bronchi in the upper lobes. Granulomatous vasculitis affected medium-sized pulmonary arteries, frequently showing granulomas in adventitia, followed by dense perivascular fibrosis. These results suggest that marked narrowing of large bronchi due to fibrosis, with fibrous adhesion to the pulmonary arteries, and check valve mechanism of bronchi may induce contraction and bullous formation in the upper lobe, and lymphatic derangement due to perivascular fibrosis may be related to the extent of fibrosis.