Shintani Y, Fujiwara K, Nakagawa K, Kikui M, Yasumitsu T
Department of Surgery, Osaka Prefectural Habikino Hospital.
Nihon Kokyuki Gakkai Zasshi. 2001 May;39(5):333-7.
CASE 1. A 55-year-old man was admitted because of an abnormality in chest radiographs. Chest HRCT showed multiple cystic lesions with thick and thin walls, and nodules; and strongly suggested pulmonary eosinophilic granuloma (EG). Open lung biopsy revealed granuloma formation and a fibrotic area consistent with EG. CASE 2. A 28-year-old woman was admitted because of chest pain and dyspnea. Chest radiography revealed bilateral pneumothorax. Chest HRCT showed multiple cystic lesions with thick walls involving the entire lung. As lung biopsy revealed, proliferative lesions and cavitation containing S-100 protein-positive histiocytes, we diagnosed this case as pulmonary EG in the active stage. CASE 3. A 32-year-old woman was admitted because of dyspnea. Chest CT showed bullous changes in the lung. As an open lung biopsy revealed, honeycomb changes with S-100 protein-positive histiocytes, this case was diagnosed as the regressive phase of EG. It is known that the chest radiography and HRCT findings of EG are characteristic and vary with the stage, so a surgical lung biopsy is necessary for diagnosis of EG. It is considered that the prognosis of the active phase of EG involving the entire lung is poor.
病例1。一名55岁男性因胸部X光片异常入院。胸部高分辨率CT（HRCT）显示多个有厚壁和薄壁的囊性病变及结节；强烈提示为肺嗜酸性肉芽肿（EG）。开胸肺活检显示肉芽肿形成及与EG相符的纤维化区域。病例2。一名28岁女性因胸痛和呼吸困难入院。胸部X光检查显示双侧气胸。胸部HRCT显示多个厚壁囊性病变累及全肺。正如肺活检所示，增殖性病变及含S-100蛋白阳性组织细胞的空洞形成，我们将此病例诊断为活动期肺EG。病例3。一名32岁女性因呼吸困难入院。胸部CT显示肺部有大疱样改变。正如开胸肺活检所示，有含S-100蛋白阳性组织细胞的蜂窝状改变，此病例被诊断为EG的消退期。众所周知，EG的胸部X光和HRCT表现具有特征性且随分期而异，因此EG的诊断需要手术肺活检。据认为，累及全肺的EG活动期预后较差。
