The Diagnosis of Emphysema.

Pulmonary emphysema is generally defined anatomically. It follows therefore that pathologists have the best opportunity to diagnose emphysema accurately. Whether they take advantage of this opportunity may be doubted by observers interested in lung disease, and Wyatt, Fischer, and Sweet (1961) have called the usual criteria (gross inspection and palpation of the lung and microscopic examination of random sections) 'pathologic chimeras'. There are, however, no investigations concerned specifically with the accuracy of the routine pathological diagnosis of emphysema, such as have been made for its clinical (Fletcher, 1952) and radiological diagnosis (Knott and Christie, 1951). This communication investigates the accuracy of the usual pathological methods in two ways.