Exciting times in pulmonary pathology

Editorials EXCITING TIMES IN P U L M O N A R Y PATHOLOGY These are exciting times for pathologists interested in the lung, and this editorial and issue of Human Pathology are a tribute to the doyen o f pulmonary pathologists, Dr. A. A. Liebow. Although there is a distinguished body o f experimental work to his credit, Dr. Liebow is best known for his meticulous stud}" of human material. When one considers that the tools he has used have changed little in this century, it is obvious that it has taken a remarkable talent to develop new observations and c~)ncepts. Yet in the last ten years, often with Dr. Charles Carrington, he has developed new insights into the interstitial pneumonias, eosinophilic pneumonia,and Wegener's granuloma. In this issue, he describes yet another condition. Soon many readers of this issue will suffer from the wellknown "Liebow s y n d r o m e " - h a v i n g read an article or heard a lecture of his, one immediately recognizes a case that one has not understood or appreciated. A rapid search o f the files produces an example of Liebow's latest disease that has passed unrecognized across one's desk and microscope (and is immediately referred to him, increasing his remarkable collection of pulmonary pathology material). It is a salutary exercise to read the pulmonary section o f a pathology textbook written fifteen or so years ago. Extensive changes and new knowledge have made this chapter the most obsolete in most textbooks. This has been brought about by a n u m b e r of trends. Interest from clinicians, stemnfing from the conquest o f tuberculosis and the rise o f clinical puhnonary physiology, led to reassessment of the simple anatomy of the lung in relation to pulmonary function as well as the rediscovery o f the pathology of pulmonary emphysema and chronic bronchitis. Weibel has primarily been responsible for the quantitative approach to h m g morphology, anti quantitative techniques have been applied profitably to pulmonary pathology. More recently, observers have begun to appreciate that the Itmg has extensive metabolic functions; and the mainstream of interest in the lung is rapidly passing beyond the reahn of whole-organ physiologists. Recognition of the importance of bronchioles in the genesis o f airways' obstruction has led to a

new interest in the biology of these air.waysl Thus, the cellular biology of the lung is under active investigation in man)" laboratories. T h e investigation of the principles of. the general pathology of the lung are only just starting, and perhaps immunologic investigation is the best developed at present. All these areas are rapidly developing and represent fields for which pathologistsare ideally equipped, technically and temperam.entally. Exciting times, indeed. W. M. Thurlbeck, M.D.

A PRECEDENT FOR HUMAN PATHOLOGY In the short publishing history of-"~uman Pathology we have devoted the pages of the journal to the very best papers in the field. O u r general policy has been to accept manuscripts o f modest length after approval by the Editorial Committee. When excellent contributions were l e n g t h y , we w o r k e d with the author(s) to reduce the material to a reasonable size. However, Dr. Liebow's manuscript fell into a new category. It was a meticulous clinical and pathological presentation of a new entity in pulmonary disease for all serious students of h u m a n patholog-y. After careful review and evaluation by the Editorial Committee, it was decided to give the reader the entire unabridged original, text and illustrations. We sincerely believe tlmt this major paper will stand as a classic in the contemporary pathology literature. It gives the reader at one time and in one place the whole story without need to look or wait for future instalhnents. T h e Editors take great pride in presenting Dr. Liebow's paper, "Lymphomatoid Granulomatosis." Human l'atholo~" will constantly be on the alert for outstanding contributions of this kind. We are dedicated to bringing the reader useful, informative, thoughtful, and provocative articles, comments, and reviews. Your comments are always welcome and help us to be of greater service. Bernard M. Wagner, M.D.

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