[Interstitial lung diseases--the clinical aspects of the problem]. / Interstitsial'nye bolezni legkogo--klinicheskie aspekty problemy.

Upon analysis of 550 cases of different chronic diffuse pulmonary diseases included in a group of interstitial diseases of the lungs (IDL) the authors came to the conclusion that IDL incorporate such variants as alveolitis, pulmonary vasculitis and pulmonary hemorrhages; granulomatosis covers exogenic allergic alveolitis, alveolitis in chronic active hepatitis; vasculitis group includes such rare diseases as necrotizing sarcoid granulomatosis vasculitis and lymphoid granulomatosis; fibrosing alveolitis--secondary alveolitis in sclerodermia systematica, rheumatoid arthritis, Sjogren's disease, chronic active hepatitis. Knowledge of IDL etiology (environmental, occupational, induced by radionuclides, drugs, viruses, fungi) with focus on drug affection of the lungs is thought of value. Biopsy and bronchial lavage findings are compared clinically and morphologically. Mechanisms of pulmonary fibrosis and approaches to inhibition of pulmonary fibrosis progression are outlined.

[Variants and stages in the course of idiopathic fibrosing alveolitis]. / Varianty i stadii techeniia idiopaticheskogo fibroziruiushchego al'veolita.

Clinicomorphological analysis covered 41 cases of idiopathic fibrosing alveolitis (IFA). The comparison of the degree of respiratory insufficiency, hypoxia, survival of the patients with cytogram of the bronchoalveolar lavage, morphological findings, generation of active oxygen forms by alveolar macrophages and leukocytes has provided evidence on an important role of alveolar macrophage in interstitial alveolitis and fibrosis in IFA. Three variants of chronic IFA are distinguished: aggressive, persistent and slowly progressive. The variants have different prognosis and need individual therapeutic approach.

[The clinico-morphological characteristics of interstitial lung diseases]. / Kliniko-morfologicheskaia kharakteristika interstitsial'nykh boleznei legkikh.

Electron microscopic and immunohistochemical methods were employed to study composition of collagens in extracellular matrix and quantify oncoproteins c-sis and c-fos. It was established that interstitial pulmonary diseases of various etiology are characterized at early stages by alveolitis with activation of alveolar macrophages, at late stages by interstitial fibrosis with accumulation of collagens type I, III, IV and V and epithelial dysplasia which is likely to initiate bronchioloalveolar cancer.

[Idiopathic fibrosing alveolitis and bronchioloalveolar cancer]. / Idiopaticheskii fibroziruiushchii al'veolit i bronkhiolo- al'veoliarnyi rak.

A case of bronchiolo-alveolar carcinoma (BAC) developing in the presence of idiopathic fibrosing alveolitis (IFA) in a man of 67 with a long history of pulmonary lesion is described. A honeycomb bung was found at the autopsy. Histologically, multiple foci of BAC of mixed-cell structure and those of mucus-producing cells against the background of fibrosing alveolitis at the stage of honeycomb lung were observed. An increased content of collagen type III, IV and V was found immunohistochemically. The role of sclerotic changes and defected immunological surveillance over the epithelial regeneration in the IFA-affected lung in relevant carcinoma genesis is suggested. The origin of the lung carcinoma in IFA is considered to be the regenerating epithelium of the low respiratory tract.

[The extracellular matrix of peripheral lung cancer in the scar and of pneumosclerosis of different origins (the immunohistochemistry and electron microscopy of the collagens)]. / Ekstratselliuliarnyi matriks perifericheskogo raka legkogo v rubtse i pnevmoskleroza razlichnogo proiskhozhdeniia (immunogistokhimiia i élektronnaia mikroskopiia kollagenov).

Collagen types and ultrastructural features of the stroma and scar extracellular matrix in the peripheral lung carcinoma, post-tuberculosis and post-pneumonia pneumosclerosis foci, fibrosing alveolitis interstitium were studied on the material of operational and transbronchial lung biopsies. It is established that by the collagen composition the scars in the peripheral carcinoma are identical to the pneumosclerosis foci and are distinguished from the carcinoma stroma by a higher concentration of type IV and V collagens (p less than 0.05). Accumulation of type III collagen in the lung carcinoma stroma reflects anaplasia of the tumour as the domination of type III collagen is characteristic of the embryonal tissue. The decrease of collagen type IV in the cancer stroma correlates with an increase of its malignancy. Pneumosclerosis in the fibrosing alveolitis is distinct from the focal forms of pneumosclerosis by a higher content of collagen I and a lower content of collagen V this being probably due to the character of sclerosis morphogenesis in this disease.