Smoker's Lung: Pathology Photo Essay (cont.)
Are smokers with COPD predisposed to developing pneumonia?
The answer is yes. As previously mentioned, smoking increases mucus
production and impairs the clearing action of the cilia in the airway. Also, the
addition of bacteria, inflammatory cells, and damaged lung cells to the
secretions in the airway and lung make the secretions especially thick,
tenacious, and difficult to clear. Therefore, in such a stagnant and nutritious
(the mucus) environment, bacteria can flourish and cause infection of the lung
(pneumonia).
Furthermore, even the inflammatory cells are damaged by tobacco
smoke so that their ability to fight infection is diminished.
For all of these reasons, pneumonia is not only more common, but it is often
also more severe in smokers with COPD (chronic obstructive pulmonary disease,
that is, emphysema and/or chronic bronchitis) than in non-smokers without COPD.
Moreover, the inflammatory cells that accumulate in the lung to fight off the
infection can fill the alveolar spaces and thereby further limit diffusion of
oxygen and carbon dioxide. Therefore, smokers with COPD, who already have
impaired breathing (pulmonary function), often become much worse when there is a
superimposed infection of the lung (pneumonia).
Figure 7 is a microscopic section of a lung with
pneumonia in a patient with COPD.
Figure 7: PNEUMONIA IN COPD
Notice that most of the alveoli are filled with inflammatory cells. Some
alveoli, however, are unaffected and empty because the involvement of this lung
with pneumonia is patchy.
Next: What about lung cancer in smokers? »
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