Diagnostic fiberoptic bronchoscopy (FBS) was performed on 60 CLL patients who did not abuse smoking and outside the administration of AML (20 patients of group I, 20 patients of group II, and 20 patients of group III). All patients of group I had a bronchoscopic picture of a normal tracheobronchial tree. But 10 patients had vascular injection.
In 10 patients of the II group, when conducting PBS, bilateral diffuse endobronchitis was diagnosed, the intensity of inflammation (IW) of the I degree. Not marked hyperreactivity of the bronchi. These patients had no clinical manifestations of bronchitis. A bronchoscopic picture of a normal tracheobronchial tree was diagnosed in 10 patients of group II. In 15 patients of this group, plethora and vasodilation were noted.
In 14 patients of the third group, fibrobronchoscopy was diagnosed with bilateral diffuse endobronchitis, IV – 1 and II degrees (12 and 2 people, respectively). No bronchial hyperreactivity was detected. Only four patients noted a slight cough in the morning. Other patients had no clinical symptoms of bronchitis. A bronchoscopic picture of a normal tracheobronchial tree was observed in 6 patients of group III. Expansion and plethora of blood vessels were diagnosed in 16 patients , which in CLL is a manifestation of hemoblastosis, and not bronchopulmonary pathology.
Thus, during fibrobronchoscopic examination, 60% of patients with a progressive course of CLL (40% of the total number of patients with CLL) were diagnosed with a latent course of chronic non-obstructive bronchitis.
Endobronchial biopsy was performed on 10 patients of group I, 10 patients of group II, and 5 patients of group III. Topeka biopsy specimens – 1.5 cm distal to the spur of the right upper lobe bronchus. Patients of group I were diagnosed with moderate proliferation or dystrophy of the bronchial epithelium. In patients with benign CLL, no lymphoid infiltration of the bronchi was detected. In patients with groups II and III, the histological examination of biopsy specimens determined the signs of chronic inflammation, edema, atrophy of the bronchial mucosa, and focal squamous metaplasia of the epithelium was often noted. Under the basement membrane revealed diffuse lymphocytic infiltration of varying severity. Most lymphoid infiltration was expressed in patients of group III.