Zsiray M, Appel J, Lantos A
Pulmonológiai Klinika, Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 1999 May 30;140(22):1239-43.
224 transbronchial biopsies were made between 1990 and 1997 in 208 patients suffering diffuse, bilateral, disseminated pulmonary diseases with unidentified origin. The examinations were carried out by flexible bronchoscope with X-ray control after local anaesthesia. The obtained patterns yielded mucous membrane in 15, intact alveoli in 19 percent. In 25 percent of biopsies (57 cases) definitive diagnosis were verifiable. The histological examinations verified the diagnosis of sarcoidosis, hemosiderosis, TB, malignancies, eosinophil pneumonitis etc. In 71 biopsies (62 cases) according to histological opinion were pulmonary fibrosis or some synonyms of these (alveolitis, interstitial fibrosis). From these latter cases the documentation of 18 patients were insufficient, but the data of 44 cases were available. 7/44 carcinosis, 3/44 inactive TB, 8/44 regressive X-ray patterns were verifiable in this group. The idiopathic pulmonary fibrosis as final diagnosis only in 18/44 (41%) cases were established. Further diagnostic procedures are needed if the clinical data, the results of HRCT and histological examinations are not in correlation.
1990年至1997年间，对208例患有弥漫性、双侧性、播散性且病因不明的肺部疾病的患者进行了224次经支气管活检。检查在局部麻醉后通过带X线控制的可弯曲支气管镜进行。所获得的标本中，15%为黏膜组织，19%为完整肺泡组织。25%的活检标本（57例）可明确诊断。组织学检查证实了结节病、含铁血黄素沉着症、结核病、恶性肿瘤、嗜酸性粒细胞性肺炎等疾病的诊断。71例活检标本（62例患者）根据组织学观点诊断为肺纤维化或其一些同义词（肺泡炎、间质性纤维化）。在后一组病例中，18例患者的资料不充分，但44例患者的数据可用。该组中可证实7/44为癌，3/44为静止期结核，8/44为退行性X线表现。仅在18/44（41%）的病例中确立了特发性肺纤维化的最终诊断。如果临床资料、高分辨率CT结果和组织学检查结果不相关，则需要进一步的诊断程序。
