Yokohori N, Homma S, Tanaka S, Kawabata M, Kishi K, Tsuboi E, Narui K, Nakatani T, Nakata K
Department of Respiratory Disease, Toranomon Hospital, Tokyo.
Nihon Kokyuki Gakkai Zasshi. 1999 Jul;37(7):583-8.
We report a case of exogenous lipoid pneumonia induced by insecticide. A 67-year-old man was admitted to our hospital with complaints of dyspnea cough, hemoptysis, and shivering 6 hours after inhaling an insecticide. A chest radiograph on admission disclosed consolidation in the right upper lobe. Chest computed tomography showed nodular infiltrates associated with ground-glass opacities. Bronchoalveolar lavage fluid was hemorrhagic and showed neutrophilia. Pathological examination of transbronchial lung biopsy specimens showed numerous vacuolated macrophages in alveolar spaces. Electron microscopy demonstrated lipid droplets in the cytoplasm of these macrophages. These findings together yielded a diagnosis of exogenous lipoid pneumonia induced by insecticide. In addition, we experimentally induced a similar form of lipoid pneumonia in rats by intratracheal instillation of the same insecticide.
我们报告一例由杀虫剂引起的外源性类脂性肺炎病例。一名67岁男性在吸入杀虫剂6小时后,因呼吸困难、咳嗽、咯血和寒战入院。入院时胸部X光片显示右上叶实变。胸部计算机断层扫描显示结节状浸润并伴有磨玻璃样混浊。支气管肺泡灌洗液呈血性且显示中性粒细胞增多。经支气管肺活检标本的病理检查显示肺泡腔内有大量空泡化巨噬细胞。电子显微镜检查显示这些巨噬细胞的细胞质中有脂滴。这些发现共同得出由杀虫剂引起的外源性类脂性肺炎的诊断。此外,我们通过气管内滴注相同的杀虫剂在大鼠中实验性诱导出了类似形式的类脂性肺炎。