From Big Medical Encyclopedia

CARNIFICATION (Latin caro, carnis meat + to do to facere) — the process of the organization of intra alveolar exudate giving to sites of pulmonary fabric a consistence and a type of meat. To. is a kind of a pneumosclerosis and develops in the outcome pneumonia (see), thicket croupous. To. it is observed at tubercular pneumonia — tubercular specific To. The use of the term in cases of resistant atelectases of various etiology when the pulmonary parenchyma is fallen down and burgeons connecting fabric, not sovey is justified.

To. the conditions breaking a rassasyvaniye of fibrinous exudate promote: deterioration limf, or a bronchial drainage at hron, bronchitis and recurrent pneumonia, decrease in enzymatic activity of leukocytes and alveolar phagocytes under the influence of prolonged and chaotic use of streptocides and antibiotics. At the same time there is not an autolysis of fibrinous exudate, but its organization by growth of connecting fabric. The fibroblasts growing into fibrin are rich with nucleoproteids in the beginning, between them thin argyrophil fibrils in which circle the sulphated mucopolysaccharides and hyaluronic to - that collect are visible. Over time bunches of argyrophil fibers turn into collagenic fibers, free mucopolysaccharides disappear. Elastic fibers of interalveolar partitions are broken off, remain the twisted their scraps. During the coloring on elastin among the cicatricial fabric arising in the area K., on these scraps it is possible to reveal contours of the former alveoluses and by that to establish an origin of a pneumosclerosis. In addition to fibroblasts, alveolar macrophages take part in the organization of exudate, according to some authors. Over time the young connecting fabric rich with cells and blood vessels is replaced with cicatricial. At To. in connecting fabric formation of smooth muscle fibers is possible.

Fig. 1. Microdrug of a lung in the outcome of pneumonia: full overgrowing of alveoluses young connecting fabric (1), formation of the cracks (2) covered by an epithelium; coloring hematoxylin-eosine; x 250

The organization of fibrin in alveoluses can lead to full or partial overgrowing of their gleam. At full overgrowing of alveoluses (fig. 1) among cicatricial fields sometimes there are cavities (the former cracks in fibrin) which can turn into the adenomatous educations covered by an epithelium or in angiomatous with the inner surface covered with an endothelium.

Fig. 2. Microdrug of a lung in the outcome of pneumonia: partial overgrowing by connecting fabric of an alveolus (1) and a respiratory bronchiole (2) in the form of the polyps (3) covered with an epithelium; coloring hematoxylin-eosine; X 180

At partial overgrowing of a gleam of alveoluses formation of so-called little bodies of Masson — speakers in a gleam of alveoluses of the connective tissue small knots having an appearance of the polyps on the wide basis and covered with a cubic or prismatic epithelium (fig. 2) is possible. They are described by K. Masson as specific structure for rheumatic pneumonia, however their specificity is denied. Partial overgrowing of a gleam of the next alveoluses reminds a picture of intersticial pneumonia if the mass of the organized fibrin creep on both sides of reinforced, rich cells of an alveolar partition. At To. growth of connecting fabric happens also in alveolar partitions, under a pleura, between segments, around vessels and bronchial tubes owing to what there are continuous sites of connecting fabric. To. seldom takes all lung lobe entirely; usually its certain sites are surprised. Karnifitsirovanny sites of lungs of brown-red or gray-pink color, are airless, dense, sink in water; later they shrivel, get a leathery consistence and whitish-gray color.

Clinically To. it is shown by the symptoms characteristic for pneumosclerosis (see). In the presence of the large and widespread centers To. there can be vicarious emphysema (see) and bronchiectasias (see). Prevention To. comes down to radical and correct treatment of acute pneumonias and bronchitis.

Bibliography: Yesipova I. K. Questions of pathology of chronic nonspecific pneumonias, M., 1956, bibliogr.; it, Pathological anatomy of lungs, page 112, M., 1976; Strukov A. I. and Kodolova I. M. Chronic nonspecific diseases of lungs, M., 1970, bibliogr.; Sh e x t of e r A. B. and M and-lovanova 3. P. Fibroblast — fib-rock flippers, Arkh. patol., t. 37, No. 3, page 13, 1975, bibliogr.; G e g 1 an U. H. Die idio-patisch fibrosierende Alveolitis, Stuttgart, 1977; Spencer H. Pathology of the lung, v. 1 — 2, Oxford, 1977.

I. K. Yesipova.