[Vascular changes in genesis of necrotic and inflammatory lesions of the lungs in Wegener's granulomatosis].

Clinico-morphological and histochemical studies of changes in the lungs were carried out in 15 fatal cases of Wegner's granulomatosis. Morphological manifestations of the lesions consisted in bilateral extensive destructive-productive panangiitis in the system of bronchial, was well as pulmonary arteries and veins. As a rule, there developed an extremely polymorphic granular tissue which subsequently underwent necrosis with resulting cavern formation. Deep and sometimes irreversible changes observed in the vessels of the microcirculatory bed led to alveolar-capillary blockade and hypoxia, the latter culminating with circulatory crisis. Drastic dyscirculatory disorders were complicated with auto- and superinfection: development of destructive-suppurative bronchitis, peribronchitis, interstitial and also confluent pneumonia with "motley" exudate in alveoli, not infrequently with an abscess formation, sometimes with formation of hyaline membranes. The whole complex of these changes play a significant part in pathogenesis of pulmonary-cardiac insufficiency occurring in the majority of patients with Wegener's granulomatosis and often is responsible for fatal outcomes.