Yamamoto Noriko, Yoshii Chiharu, Kawajiri Tatsunori, Ominami Satoshi, Matsumoto Yuko, Ito Toshiro, Hayashi Toshinari, Kido Masamitsu
Department of Respiratory Disease, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu City, 807-8555 Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 Apr;40(4):316-20.
We report a case of pulmonary eosinophilic granuloma with the latest onset ever reported in Japan. A 72-year-old woman, a current smoker, developed dyspnea and dry cough in late January 2001. Chest radiography and CT examinations revealed numerous small nodular lesions and multiple cysts in both upper lung fields. A thoracoscopic lung biopsy revealed a granulomatous lesion composed of eosinophils and large histiocytic cells with pale eosinophilic cytoplasms and large cleaved nuclei. These cells gave a positive reaction for S-100 protein. These findings led to a diagnosis of pulmonary eosinophilic granuloma. This disease is generally reported in much younger subjects, and few cases are known in those over 60-years old. No Japanese report of histologically confirmed pulmonary eosinophilic granuloma in an older patient has previously appeared, but it may now be prudent to take this disease into consideration when diagnosing pulmonary disease in older subjects.
我们报告一例日本国内迄今发病年龄最大的肺嗜酸性肉芽肿病例。一名72岁女性，目前仍在吸烟，于2001年1月下旬出现呼吸困难和干咳。胸部X线和CT检查显示双上肺野有大量小结节病变和多个囊肿。胸腔镜肺活检显示为肉芽肿性病变，由嗜酸性粒细胞和大组织细胞组成，后者具有淡嗜酸性细胞质和大的核裂。这些细胞对S-100蛋白呈阳性反应。这些发现导致诊断为肺嗜酸性肉芽肿。该病通常在年轻得多的患者中报道，60岁以上患者中已知病例很少。此前日本尚无组织学确诊的老年患者肺嗜酸性肉芽肿的报告，但现在在诊断老年患者的肺部疾病时考虑这种疾病可能是谨慎的做法。
