[The number and density of hypertensive vascular lesions of lung in advanced pulmonary hypertension--a computer 3-D morphometry in autopsy lung specimens of 5 patients with congenital cardiac anomaly].
To study how and to what degree the vascular bed of the lung is narrowed in patients with advanced pulmonary hypertension, the number and density of advanced pulmonary vascular lesions in lung tissue were determined by 3-dimensional morphometry. The material included 17 autopsy lung specimens taken from different lobes of 5 patients ranging from 2 to 17 years and dying of congenital cardiac anomalies. In each specimen, computer-aided 3-D reconstruction was performed from serial sections, and the number of grade 3 and 4 lesions was counted in the computer display, also with their densities calculated. The number and density of obstructive vascular lesions were found varying to an unexpected degree, with a marked difference among the individuals and among the site of the lung. The total number of plexiform lesion tends to be greater in the lower lobes. The degree of vascular bed narrowing, defined as the numerical ratio of the obstructed to the total of what we call "acinar arteries", was also various, suggesting that there can be patients who, having a bed not strongly narrowed, are operable even in the presence of plexiform lesion. On the other hand, the result of morphometry provided a basis on which the reliability of open lung biopsy is to be re-assessed: it disclosed the need of semi-serial sectioning of specimen in order not to be missed plexiform lesions particularly when their density in the lung is very low.
Matsuki
K
K
Department of Pathology, Tohoku University School of Medicine, Sendai, Japan.
Takahashi
T
T
Mohri
H
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000473:pathology*; D007091:Image Processing, Computer-Assisted; D008297:Male; D011651:Pulmonary Artery / Q000473:pathology*