Pathology of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD), clinically defined by airflow limitation, has a heterogeneous underlying lung pathology, involving all lung compartments: large and small airways, and lung parenchyma, that all can contribute to the disease manifestation to a varying extent and in several different combinations leading the same clinical presentation of COPD. In the present article, mainly the classic pathological changes involved in COPD will be described with the prototypical pathology comprising chronic bronchitis, emphysema and small airways disease with distinct anatomical, pathological and clinical characteristics. Knowledge of the pathology is the basic starting point for understanding COPD pathogenesis and together with immunology, cell biology, physiology and genomics, as described in other chapters, for understanding the underlying variation in pathophysiology and clinical presentation and finding possible ways of new targets for intervention.