Lobar distribution of bronchiolar inflammation in emphysema.

Inflammation in the membranous and respiratory bronchioles was graded in the upper and lower lobes of 37 excised human lungs to see if lobar differences were present. In the 17 emphysema-free lungs, the inflammation scores of the membranous bronchioles were significantly higher in the lower lobes, but there was little lobar difference in the scores of the respiratory bronchioles. In the 17 lungs with emphysema of greater degree in the upper lobe, the inflammation scores of the respiratory bronchioles were significantly higher in the lower lobes and there was a trend for the scores of the membranous bronchioles to be higher in the lower lobes. In 8 of these lungs, pure centrilobular emphysema was present, and in these lungs the inflammation scores of both bronchioles also tended to be higher in the lower lobes. There were only 3 lungs with pure panlobular emphysema of greater degree in the lower lobes. The results of this study indicated that the distribution of membranous and respiratory bronchiole inflam...