PEDIATRICS Vol. 64 No. 2 August 1979, pp. 165-171
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Persistent Localized Pulmonary Interstitial Emphysema and Lymphangiectasia: A Causal Relationship?

John C. Leonidas MD1, Ina Bhan MD1, and Roy G. K. McCauley MD1

1 Departments of Pediatric Radiology and Pediatric Pathology of the New England Medical Center Hospital and Tufts University School of Medicine, Boston

The mechanism responsible for persistent regional pulmonary interstitial emphysema under tension, which occasionally complicates assisted ventilation, has not been explained. It is difficult to comprehend how interstitial air may cause lobar hyperinflation and not escape to the mediastinum or pleura. Histologic examination of resected emphysematous lung in two neonates with this type of interstitial emphysema revealed air dissecting from the interstitial connective tissue into markedly dilated lymphatics. It is proposed that intralymphatic air dissection causing emphysematous lymphangiectasia may be responsible for fixation of the lung in the emphysematous state.

Submitted on September 11, 1978
Accepted on December 12, 1978




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