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30CONGENITAL AND ACQUIRED STRUCTURES IN THE LUNGS OF BRONCHIECTASIS DISEASE IN CHILDREN Blinova S.A.1, Khamidova F.M.2, Ismailov J.M.3
1Blinova Sofya Anatolyevna - Professor, DEPARTMENT OF HISTOLOGY;
2Khamidova Farida Muinovna - PhD, Associate Professor, Head of Course;
3Ismailov Jasur Mardonovich - Assistant,
PATHOLOGICAL ANATOMY COURSE, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: the lobes or fragments of the lungs removed in 10 children during surgery for bronchiectasis were studied. On histological specimens ectasic bronchi are revealed. Their mucous membrane contains papillary growths, peribronchial sclerosis is marked. There is exudates with leukocytes in the lumen of the bronchi. Thus, the study made it possible to establish the presence of histological structures, reflecting the various manifestations of the pathology in bronchiectasis.
Keywords: lungs; bronchiectasis disease, structures, children.
Introduction. Bronchoectatic disease occupies an important place in the structure of bronchopulmonary pathology in children. In this regard, attention is not weakened to the study of various aspects of this disease, including its etiopathogenesis. The basis of the formation of bronchiectasis can be congenital and hereditary diseases. Congenital malformations of the bronchopulmonary system are revealed in 8-10% of patients with chronic inflammatory lung diseases [4, 6]. It was found that only 18.0% of patients with bronchiectasis had a congenital character. At the same time, it turned out that 38.5% of children had a genetic predisposition for respiratory organs diseases [5, 7]. There is evidence that chronic pulmonary suppurations, subjecting to surgical treatment, in 66% of children is due to congenital defects of the lungs [2]. However, according to tne findings of a number of researchers, even with careful differential diagnosis in 26-53% of cases, the cause of the formation of bronchiectasis cannot be established [8, 9].
Purpose of the study. To reveal the presence of histological structures reflecting the signs of congenital and acquired pathology in children with bronchiectasis.
Material and research methods. The lobes or fragments of the lungs removed in 10 children during surgery for bronchiectasis were studied. From the surgical material, 5-7 pieces are cut out, which are fixed in Buen's fluid and embedded in paraffin. Step sections are stained with hematoxylin and eosin, according to Van-Gieson, resorcin-fuchsin Weigert, impregnated with silver nitrate according to Grimelius.
The results of the study and their discussion. On histological specimens ectasic bronchi are revealed. Their mucous membrane contains papillary growths, peribronchial sclerosis is marked. There is exudates with leukocytes in the lumen of the bronchi. Ihe respiratory portion is represented by both emphysematous dilated alveoli and atelectatic areas. There is serous fluid in the alveoli. Lymphoplasmocytic infiltration is noted in the interstitium. There are alveolar macrophages in the lumen of some alveoli. Dystrophic changes of glands, death of secretory cells are noted. In some cases, chronic inflammation leads to a dystrophic change in cartilages. The changes described above indicate the presence of a purulent inflammatory process that accompanies bronchiectasis. In addition to the structures reflecting the manifestations of a chronic non-specific inflammatory process, signs of congenital and acquired character were noted in the lungs of patients. In all the studied cases, we noted some signs that indicate the inheritance of this pathology. Adipose tissue around the large bronchi is often revealed. In addition, attention is drawn to the presence of cartilage of irregular shape, which is also considered as a congenital malformation. The bronchial tree underdevelopment
is manifested in the fact that a large number of small bronchial tubes are located on the territory of the large bronchi. Similar accumulations of small diameter bronchial tubes can also be seen in the respiratory region. In these areas of the lung parenchyma elastic fibers are not revealed. Along with this, the preparations also contain formed pulmonary acini. Congenital structures should also include the constant detection of the APUD-system - apudocytes, both single and small groups of 2-5 cells. Acquired structures are represented by accumulation of clusters of lymphoid tissue (BALT), which forms both diffuse clusters and lymph nodules, besides single lymphocytes are found throughout, which penetrate into the bronchial epithelium. Lymphatic nodules are located in the peribronchial tissue and they, often have large sizes. Many lymph nodules have a reactive center, in some cases it looks empty. The presence of BALT reflects an increase of immune processes and normally they are not marked [10]. The destruction of reactive centers is apparently due to the "breakdown" of the compensatory role of immune structures. A study of the clinical and functional consequences of bronchopulmonary dysplasia in children, adolescents and young adults showed a long-term persistence of impaired respiratory function, including impaired bronchial obstruction, reduced lung diffusion capacity, and bronchial hyper reactivity in these patients at an older age. The classification of patients with malformations of the lungs in the case history of the risk group for the early development of chronic obstructive pulmonary disease has been substantiated [1]. Chronic bronchitis and bronchiectasis can also develop on this basis [3].
Conclusions. Thus, the study made it possible to establish the presence of histological structures, reflecting the various manifestations of the pathology in bronchiectasis. The presence of signs of lung underdevelopment in all cases suggests their fundamental role in the development of this disease.
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