Watanabe K, Aritomi T, Yoshida M, Kikuchi M, Watanabe T
Second Department of Medicine, School of Medicine, Fukuoka University.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Jul;30(7):1234-41.
In 11 autopsy cases of acute onset interstitial pneumonia of unknown etiology, all cases had thickening of alveolar septa with various degrees of lymphocytic infiltration and fibroblast proliferation. Only a few cases had edematous alveolar septa, which were weakly positive in alcian-blue staining. Intra-alveolar, intra-alveolar duct and intra-bronchiolar organization was a characteristic finding. These findings may represent the repair phase rather than the exudative phase of diffuse alveolar damage. Localized bacterial pneumonia was superimposed in 3 cases, and neither Pneumocystis carinii nor viral inclusion bodies were identified in any case. The severity of fibrosis was not obviously correlated with the period of artificial ventilation. From these findings, terminal infection and oxygen therapy did not seem to significantly modify the course of acute-onset interstitial pneumonia. Further examination of autopsy cases as well as open-lung biopsy is important to elucidate the time course of acute-onset interstitial pneumonia.
在11例病因不明的急性起病间质性肺炎尸检病例中，所有病例均有肺泡间隔增厚，伴有不同程度的淋巴细胞浸润和成纤维细胞增生。仅有少数病例肺泡间隔水肿，阿尔辛蓝染色呈弱阳性。肺泡内、肺泡管及细支气管内机化是特征性表现。这些表现可能代表弥漫性肺泡损伤的修复期而非渗出期。3例合并局限性细菌性肺炎，所有病例均未发现卡氏肺孢子虫及病毒包涵体。纤维化程度与人工通气时间无明显相关性。根据这些发现，终末期感染和氧疗似乎并未显著改变急性起病间质性肺炎的病程。进一步检查尸检病例及开胸肺活检对于阐明急性起病间质性肺炎的病程很重要。
