Rolfe M W, Paine R, Davenport R B, Strieter R M
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor 48109-0360.
Am Rev Respir Dis. 1992 Dec;146(6):1600-2. doi: 10.1164/ajrccm/146.6.1600.
Hard metal pneumoconiosis is a recently recognized occupational lung disease associated with the exposure to cobalt fumes in the workplace. Chronic exposure in susceptible individuals results in interstitial lung disease histopathologically manifested as interstitial fibrosis with an associated mononuclear cell infiltrate and the presence of "cannibalistic" multinucleated giant cells in the alveolar airspaces. The majority of patients present with symptoms of chronic cough and dyspnea. Interestingly, in addition, patients uniformly report significant weight loss out of proportion to their degree of respiratory impairment. In this case report we demonstrate the association of tumor necrosis factor-alpha (TNF) and hard metal (cobalt) pneumoconiosis and suggest that TNF may have a potential role in the etiology of the constitutional symptoms and the pathogenesis of interstitial lung disease.
硬质金属尘肺是一种最近才被认识到的职业性肺病，与工作场所接触钴烟雾有关。易感个体长期接触会导致间质性肺病，其组织病理学表现为间质纤维化，并伴有单核细胞浸润以及肺泡腔中出现“自噬性”多核巨细胞。大多数患者表现出慢性咳嗽和呼吸困难的症状。有趣的是，此外，患者均报告有与呼吸功能损害程度不相称的显著体重减轻。在本病例报告中，我们展示了肿瘤坏死因子-α（TNF）与硬质金属（钴）尘肺之间的关联，并表明TNF可能在全身症状的病因以及间质性肺病的发病机制中发挥潜在作用。
