EARLY PHASES OF PHOSGENE POISONING IN LIGHT MICROSCOPIC, ELECTRON-MICROSCOPIC AND ROENTGENOLOGICAL STUDIES

The first changes in dog lungs occurring after short time inhalation of phosgene were examined by comparative x-ray studies and by light and electron microscopy. The first changes were found in the alveolar wall 1 1/2 hour after inhalation: The alveolar epithelium appeared intensively folded. The alveolar wall was edematous and the alveoli contained a cell-free exudate. The peripheral parts of the lung were emphysematous. The edema increased during the first hours. After rupture of the alveolar walls the exudate contained fibrin and cellular debris. Alveolar phagocytes resembling the proliferated corner cells with numerous, mostly lamellar inclusions, increased in number. Six to eight hours after phosgene inhalation a severe bronchiolitis had developed with some necroses. A lymphostasis occurred in the peribronchial interstitium. Roentgenograms at four hours revealed only acute emphysema. Six hours after inhalation a lung edema was recognizable in the radiograms. In the further development the roentgenological and morphological findings corresponded. Our results indicate severe morphological lesions while roentgenograms show only slight changes during the first hours after phosgene inhalation. Therapy should be instituted when the roentgenological alterations first become apparent. © 1969 Springer-Verlag.