THE EARLY LESIONS IN PULMONARY EMPHYSEMA
Published Apr 1, 1962 · R. Mitchell, G. Toll, G. Filley
The American Journal of the Medical Sciences
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Abstract
From its Greek derivation, the word "emphysema" is often assumed to mean merely "blown up." A number of studies and recent concerted attacks upon the problem of definition of this and related conditions now ascribe a different meaning to the word "emphysema." Authorities in both the United Kingdom and the United States now seem to be in agreement that emphysema should be defined in strictly morphologic terms.' 2 In short, emphysema is essentially a destruction of alveolar walls. Simple air space dilatation, if it can be distinguished from alveolar wall destruction, does not constitute emphysema unless it has become irreversible. Enlargement of the lungs may occur without evidence of tissue destruction and in this circumstance should be described by terms such as overdistention or "air trapping" unless the dilatation can be demonstrated to be permanent. In this paper we will use the word "emphysema" to refer to a pulmonary disease whose definition depends on morphologic criteria but whose diagnosis and early detection in life depend respectively on clinical and physiologic data constituting presumptive evidence of tissue destruction.