The gross postmortem diagnosis of chronic obstructive pulmonary disease (COPD) and its differential diagnosis with senile lungs on autopsy specimens are much difficult if clinical, X-ray, and functional findings are absent. The diagnosis of COPD is now possible only if medical history and clinical data, external respiratory function, and disease severity are considered and compared with the gross and microscopic autopsy pattern, by obligatorily evaluating the state of collagen and elastic fibers. Taking into account the current definition and essence of COPD, it is expedient to reconsider existing stereotypes in the postmortem diagnosis of this disease, by focusing our efforts on the study of its morphologic substrate, patho-, and morphogenesis.

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