Shahd Alali has chronic bronchitis, characterized by a chronic cough lasting over 2 years. Chronic bronchitis is common among smokers and is caused by smoking as well as air pollutants. It involves hypertrophy of the bronchial mucus glands leading to hypersecretion of mucus and inflammation in the large airways. On morphology, the large airways appear hyperemic, swollen, and covered in mucus secretions with increased goblet cells and inflammatory cells in the trachea and bronchi. Clinical features include a prominent cough producing sputum, cyanosis, increased risk of infection, and dyspnea.

1. SHAHD ALALI
CHRONIC BRONCHITIS

2. • It is characterized by a chronic productive cough
lasting at least 3 months over a minimum of 2 years.
• Common among smokers
• Most have both emphysema & chronic bronchitis
• Early stages of the disease:
• Productive cough
• Mucoid sputum

3. ETIOLOGY
• Smoking
• Air pollutants
• Sulfur dioxide
• Nitrogen dioxide
• Cystic fibrosis
• Coexistent emphysema
• Experimental evidence: Increase transcription of
mucin gene

4. PATHOGENESIS
• Charactirized by hypertrophy of bronchial mucinous
glands thus hypersecretion of mucus
• Increased thickness of mucus glands (Reid index
increases to >50%)
• Casing inflammation (CD8+, lymphocytes….
• In contrast with asthma there are no eosinophils
• Microbial infection often is present

6. MORPHOLOGY
• Large airways gross specimens:
• Hyperemic
• Swollen by edema fluid
• Covered by a layer of mucinous secretion
• Increase of goblet cells
• Histological examination of trachea & bronchi:
• Enlargement of mucus-secreting glands
• Inflammatory cells (mononuclear / mixed with
neutrophils)

7. • Chronic bronchiolitis:
• Goblet cell metaplasia
• Mucous plugging
• Inflammation
• Fibrosis

10. CLINICAL FEATURES
• Prominent cough & production of sputum
• Cyanosis “Blue bloaters”
• Increase risk of infection
• Tend to be stocky or obese
• Wheezing
• Hypoxemia
• Dyspnea

11. PULMONARY FUNCTION TEST
• Less increased TLC & RV than emphysema
• Chronic respiratory acidosis

12. COMPLICATIONS
• Respiratory failure
• Cor pulmonale