Summary
150 cases of chronic inflammatory lung diseases of unknown aetiology and assumed hyperergic (immuno-reactive) pathogenesis were examined for hypertensive pulmonary arterial lesions and for chronic cor pulmonale. Hypertensive lesions of the small pulmonary arteries were found in more than half of the cases with chronic disorders of long duration, but were inconspicuous in diseases of acute progressive character. Hypertensive lesions were found regularly in chronic interstitial pneumonia, frequently in scleroderma and rheumatoid arthritis and occasionally in dermatomyositis and disseminated lupus erythematosus. Chronic Cor pulmonale occurred in 16% of the cases with hypertensive arterial lesions of grade I (hypertrophy of media) and in 50% of grade II/III (hypertrophy of media and intimai fibrosis). Interstitial lung fibrosis plays an important role in the pathogenesis of cor pulmonale: two thirds of the cases with interstitial lung fibrosis had developed cor pulmonale and all the cases with cor pulmonale also had interstitial lung fibrosis.
Hypertensive arterial lesions of grade IV–VI according to Heath and Edwards (angiitis, plexogenic and angiomatoid lesions) have been described in severe cases of pulmonary hypertension (congenital cardiac shunts, primary pulmonary hypertension). In secondary forms of pulmonary hypertension, as represented by our material, these changes are of little importance.
Similar content being viewed by others
Literatur
Aitchison, J.D., Williams, A.W.: Pulmonary changes in disseminated lupus erythematodes. Ann. Rheum. Dis. 15, 26–32 (1956)
Caldwell, I.W., Aitchison, J.D.: Pulmonary hypertension in dermatomyositis. Br. Heart. J. 18, 273–276 (1956)
Doerr, W.: Organpathologie, Ed. I., pp. 3–7. Stuttgart: G. Thieme 1974
Edge, J.R., Richards, A.G.: Rheumatoid arthritis with lung lesions. Thorax 12, 352–357 (1957)
Ellman, P., Ball, R.-E.: Rheumatoid disease with joint and pulmonary manifestations. Br. Med. J. ii, 816–820 (1948)
Fishman, A.P.: Plexiform lesions. Path. Microbiol. 43, 242–245 (1975)
Gardner, D.L., Duthie, J.J.R., McLead, J., Allen, W.S.A.: Pulmonary hypertension in rheumatoid arthritis. Scot. Med. J. 2, 183–188 (1957)
Harris, P., Heath, D.: The human pulmonary circulation. Edinburgh, London and New York: Churchill Livingstone 1977
Harrison, C.V.: The pathology of the pulmonary vessels in pulmonary hypertension. Br. J. Radiol. 31, 217–226 (1958)
Hatano, S., Strasser, T. (Eds.): Primary pulmonary hypertension, report on a WHO-Meeting 1973. Geneva: WHO 1975
Heath, D., Edwards, J.E.: The pathology of hypertensive pulmonary vascular disease. Circulation 18, 533–547 (1958)
Leu, H.J.: Zur Pathologie der Lungenveränderungen bei der Wegenerschen Granulomatose, der primär-chronischen Polyarthritis und der Polyarteriitis nodosa. Zbl. allg. Path. 123, 36–44 (1979)
Liebow, A.A.: Pulmonary emphysema with special reference to vascular changes. Am. Rev. Resp. Dis. 80, 67–93 (1959)
Rakov, H.L., Taylor, I.S.: Acute disseminated lupus erythematodes without cutaneous manifestations and with heretofore undescribed pulmonary lesions. Arch. Int. Med. 70, 88–100 (1942)
Rubin, H.E.: Pulmonary lesions in “rheumatoid disease” with remarks on diffuse interstitial pulmonary fibrosis. Am. J. Med. 19, 569–582 (1955)
Rüttner, J.R., Schneider, J., Bärtschi, J.-P., Niedermann, R.: Plexogenic pulmonary arteriopathy and liver cirrhosis (in print)
Uehlinger, E.: Die Lungen im Spannungsfeld der rheumatischen Kollagenosen. Zbl. allg. Path. 117, 307–313 (1973)
Vogt, P., Rüttner, J.R.: Das Cor pulmonale aus pathologisch-anatomischer Sicht. Schweiz. Med. Wschr. 107, 549–553 (1977)
Wade, G., Ball, J.: Unexplained pulmonary hypertension. Quart. J. Med. 26 (n.s.), 83–119 (1957)
Wagenvoort, C.A., Heath, D., Edwards, J.E.: The pathology of the pulmonary vasculature. Springfield Ill.: Charles C. Thomas 1964
Wagenvoort, C.A., Wagenvoort, N.: Pathology of pulmonary hypertension. New York: John Wiley & Sons 1977
Warnock, M.L., Kunzmann, A.: Muscular pulmonary arteries in chronic obstructive lung diseases. Arch. Pathol. Lab. Med. 101, 180–186 (1977)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Leu, H.J., Rüttner, J.R. & Hürlimann, P. Hypertensive Pulmonalarterienveränderungen bei chronisch-entzündlichen Lungenerkrankungen. Virchows Arch. A Path. Anat. and Histol. 383, 283–292 (1979). https://doi.org/10.1007/BF00430247
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00430247