Pneumosclerosis

excessive growth of connective tissue in the lungs as a result of various diseases. The term is also used in a broader meaning to group together conditions that are diverse in etiology and pathogenesis but which all lead to the development of pneumosclerosis. In the latter sense, “pneumosclerosis” is analogous to the collective concepts of chronic pneumonia as described by French medical writers and of chronic bronchitis as described by English medical writers. Differences in terminology make it difficult to analyze the morbidity of pneumosclerosis, but its growth is indubitable.

The causes for the development of pneumosclerosis are varied and include pneumonias, chronic bronchitis, bronchial asthma, influenza, tuberculosis, pneumoconioses, collagen diseases, cardiac insufficiency, childhood diseases (measles, whooping cough), traumas, and injuries caused by radiation. Often pneumosclerosis arises as a result of an allergic reaction of the bronchopulmonary system, for example, to medication. In pneumosclerosis the lung has a dense consistency and elastic tissue is replaced by connective tissue, which leads in severe cases to gross deformation and alteration of lung tissue—pulmonary cirrhosis (interstitial pneumonia).

Pneumosclerosis may be focal or diffuse. With focal pneumosclerosis there are usually no symptoms, and bronchiectasis may develop. The principal manifestations of diffuse pneumosclerosis are dyspnea, which initially occurs with physical exertion and later even when the patient is at rest, and cyanosis, which is a consequence of pulmonary emphysema and the deterioration of the respiratory function of the lungs. The cough is caused by bronchitis. Diffuse pneumosclerosis leads to a decrease in the partial pressure of oxygen in the pulmonary alveoli and a reflexive increase in the pressure in the pulmonary artery. This results in pulmonary hypertension, which in pneumosclerosis is a consequence first of functional changes and later also of morphological changes. Pulmonary hypertension with overloading of the right ventricle of the heart causes development of chronic cor pulmonale and subsequent right-ventricular cardiac insufficiency (decompensation). The data gained from percussion, auscultation, and X-ray examination are important in the diagnosis of pneumosclerosis.

Treatment consists of administration of agents that improve patency of the bronchi, antibiotics, sulfanilamides, and corticosteroid hormones; therapeutic exercises are also prescribed. Cardiac glycosides, Aminophylline, and diuretics are prescribed for cardiopulmonary insufficiency; in some cases, repeated phlebotomies are performed. Prophylaxis is accomplished by timely and careful treatment of pneumonias and bronchitis and by periodic examinations of workers exposed to industrial dust.