Popper H H
Institut für Pathologie, Karl-Franzens-Universität Graz.
Verh Dtsch Ges Pathol. 2000;84:118-28.
Our knowledge on epithelioid cell granulomatosis of the lung has been extended in recent years. New entities have been added, like zirconiosis, others like tuberculosis, mycobacteriosis and sarcoidosis have gained new interest, because molecular techniques allowed new insight into their pathogenesis and a more rapid and species-specific diagnosis. Experimental work in addition has added a lot of information about the network of cytokines and other inflammatory mediators responsible for granuloma formation, however, our knowledge of this network is still incomplete. Three types of agents are now known to cause epitheloid cell granulomas: infectious organisms (bacteria, fungi, and parasites), products of plants and animals (pollen, sporangia, proteins), and metallic compounds. In addition there is still a group of epithelioid cell granulomatoses with unknown etiology. Sarcoidosis, one of these granulomatosis, has recently elicited an old controversy: By molecular techniques Mycobacteria and Corynebacterium acnes have been identified in sarcoid granulomas and a link to the aetiology of sarcoidosis has been proposed. If these bacteria induce some cases of sarcoidosis by an allergic mechanism, has still to be proven.
近年来，我们对肺上皮样细胞肉芽肿病的认识有所扩展。新的病种被纳入其中，如锆尘肺，而其他一些疾病，如结核病、分枝杆菌病和结节病，也引发了新的关注，因为分子技术使我们对其发病机制有了新的认识，并且能够实现更快速、更具种属特异性的诊断。此外，实验研究为肉芽肿形成所涉及的细胞因子和其他炎症介质网络提供了大量信息，然而，我们对该网络的了解仍不完整。目前已知有三类因素可导致上皮样细胞肉芽肿：传染性生物（细菌、真菌和寄生虫）、动植物产物（花粉、孢子囊、蛋白质）以及金属化合物。此外，仍有一组病因不明的上皮样细胞肉芽肿病。结节病就是其中之一，最近引发了一场旧有的争议：通过分子技术，在结节病肉芽肿中已鉴定出分枝杆菌和痤疮丙酸杆菌，并有人提出它们与结节病的病因存在关联。这些细菌是否通过过敏机制引发某些结节病病例，仍有待证实。
