A Historical Perspective and Modern Techniques in Pulmonary Pathology
Moderators: Dr. Henry D. Tazelaar, Dr. Ming S. Tsao and Dr. Brendan Mullen
Section 1 -
Antiquity to Liebow- Milestones in Pulmonary Pathology
Virginia Mason Medical Center
- Many choices of what to highlight in 30 minutes
- All in room might approach topic differently
- Impossible to note all significant individuals and achievements
- All will feel someone very important to them has not been mentioned
- Highlights (of my choosing) have been selected
- Asklepios (latin Aesculapius)
- Probably a real man, lived about 1200 BCE, mentioned by Homer in Iliad.
- Became God of Medicine, son of Apolla
- Two daughters-Panacea-diety for treatment of disease
- -Hygeia-diety for health and prevention of disease
- Temples became houses of healing (early hospitals)
Early medicine-mysticisim, magic and potions
- Later-physical: baths, massage, exercise, diet, blood letting
Hippocrates (460-377 BCE) school. Air, water and "places"
Galen of Pergamon (130-200 CE) choleric, melancholic, phlegmatic, sanguine
- Dark ages (400/500-1500 CE)…Renaissance awakening of scientific thought
- Alexandria (Alexander died in 323 BCE)
- 13th century-University of Bologna
Egyptians (and South American natives)-TB, dusts, tumors
- "Silicosis is as old as mankind"
Socioeconomic changes-urbanization, crowding, poverty, sanitation, dusts, wars, injuries,
- "Before 1800s, most Europeans lived their whole lives within 10 miles of their birthsite."
Microsope-van Leeuwenhoek (1632-1723)
Germ theory-Pasteur, Kock, Jenner, Lister
Laennec (1781-1826)-invented stethoscope, wrote first treatise on Disease of the Chest.
Plagues TB used to illustrate more modern role.
- 1912 Adler found 374 cases in world's literature
- 1926 Barnard defined oat-cell carcinoma, differentiated from lymphosarcoma.
- 1928/1929 Mesothelioma debated…as possible
WHO tumor classifications-1967, 1981, 1999 Raymond Yesner
AFIP Fascicles-1952 (Liebow), 1980 (Carter and Eggleston), 1995 (Colby, Koss, Travis)
Anatomy of lung
- William Snow Miller
- Frederick Low
- Ewald Weibel
- Others-Wang, Kuhn, Lauwreyns, Thurlbeck, Hogg...
S. Donald Greenberg
Averill A. Liebow (1911-1978)
Forward 1st edition Spencer "At first glance the lungs may seem uncomplicated, but many
wise men have gone astray in their labryinth."
Later: "The lungs are a simple bellows …only to a simple fellow."
Atomic bomb casualites 1945, Encounter with Disaster, 1965
|1952 ||First Fascicle on Tumors of the lower respiratory tract.|
|1953 ||Lung musculature, high and low blood flow to lung|
Casts-injection and corrosion, Gough-Wentworth whole sections
|1956 ||Sclerosing Hemangioma (7 cases with Hubbell), |
(follow-up 1980 51 cases-Katzenstein, Gmelich, Carrington)
|1958 ||Pulmonary alveolar proteinosis/PAP. (27 cases, with Rosen)|
|1960 ||Bronchiolo-alveolar carcinoma/BAC|
|1960 ||Chemodectomas (19 cases, with Korn, Bensch, Castleman)|
|1965 ||Desquamative interstitial pneumonia/DIP (18 cases with Steer and Billingsley)|
|1966 ||Limited Wegener's granulomatosis (15 cases with Carrington)|
|1967 ||(Pulmonary veno-occlusive disease, 16 cases with Carrington)|
|1969 ||(Chronic) eosinophilic pneumonia/CEP (16 cases with Carrington)|
|1971 ||Benign clear cell sugar tumor (12 cases with Castleman)|
|1972 ||Lymphomatoid granulomatosis/LG/LYG (40 cases with Bloor and Friedman) (follow-up 1979 152 cases -Katzenstein, Carrington, Liebow)|
|1973 ||Plasma cell granuloma/PCG (40 cases with Bahadori)|
|1973 ||Bronchocentric granulomatosis/BCG (9 cases), Necrotizing sarcoid granulomatosis/NSG (11 cases)|
(follow-up 1975 BCG, MI, hypersensitivity reactions to fungi-Katzenstein, Liebow, Friedman)
|1973 ||(Bronchiolitis obliterans, 80 cases with Gosink and Friedman)|
|1974 ||UIP. BIP, DIP, LIP, GIP|
|1975 ||(Lymphangioleiomyomatosis/LAM, n= 28 cases with Corrin and Friedman)|
|1976 ||Blue bodies (19 cases)|
|1977 ||Pulmonary hyalinizing granuloma/PHG (20 cases with Engleman, Gmelich, Friedman)|
|1981 ||(Pulmonary eosinophilic granuloma/PEG…PHX/LCG/LCH, 100 cases,with Friedman and Sokoloff)|
|1983 ||Intravascular bronchioloalveolar tumor/IVBAT…EH/PEH (20 cases with Dail…), abstract 1975|
| ||( ) =expanded but did not originally define entity|
Dedications (From 1995)
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Byers JR. From Hippocrates to Virchow: reflections on human disease. Chicago: ASCP. 1988.
Loudin I, ed. The Oxford illustated history of western medicine. Oxford: Oxford
University Press. 1997.
Malkin HM. Out of the mist: foundations of modern pathology and medicine during the nineteenth
century. Berkeley: Vesalius. 1993
Harrison M. Disease and the modern world: 1500 to the present. Cambridge: Polity. 2004.
Diamond J. Guns, germs and steel: The fates of human societies. New York: WW Norton. 1997
MacCallum WG. A text-book of pathology. Philadelphia: WB Saunders 4th ed 1929.
(1st ed 1916).
Ewing J. Neoplastic diseases: a treatise on tumors. Philadelphia: WB Saunders. 3rd ed.
Winternitz MC, Wason IM, McNamara WC. The pathology of influenza. New Haven, Yale University. 1920.
Morse D, Brothwell DR. Ucko PJ. Tuberculosis in ancient Egypt. Am Rev Respir Dis 1964;90:524-541.
Murray JF. The white plague: down and out, or up and coming? Am Rev Respir Dis 1989;140:1788-1795.
Miller WS. The lung. Springfield, IL: C.C. Thomas. 2nd ed. 1947.
Spencer H. Pathology of the lung (excluding pulmonary tubercuosis). Oxford: Pergamon. 1962 (first
Glenn WWL, Liebow AA, Lindskog GE. Thoracic and cardiovascular surgery with related pathology. New
York: Aplleton-Century-Crofts. 3rd ed. 1975.
Liebow AA. Tumors of the lower respiratory tract. Washington DC: Armed Forces Institute of
Bloor CM. In rememberance of Averill A. Liebow (March 31, 1911 - May 31, 1978). Am J Pathol
Lindskog GE. Averill Abraham Liebow (1911-1978): A colleague's tribute. Yale J Biol Med
Walker Smith GJ. Averill Abraham Liebow: Contributions to pulmonary pathology. Yale J Biol Med
Dail DH, Hammar SP, Colby TV. Pulmonary pathology tumors. New York: Springer. 1995 Dedications.