Zhang Kong, Zeng Hui, Liang Guo-qing, Wang Hua
Department of Internal Medicine, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2003 Oct;26(10):623-5.
To study the clinical features of pulmonary Wegener's granulomatosis.
The data of 20 patients with Wegener's granulomatosis diagnosed during the last 20 years were retrospectively analyzed.
(1) Twelve patients (60%) with Wegener's granulomatosis presented with symptoms of respiratory system including cough, purulent sputum, bloody sputum, hemoptysis or dyspnea. In 5 of the 12 patients, the pulmonary symptoms presented as the initial manifestations. (2) Chest radiography demonstrated that Wegener's granulomatosis could involve multiple lung fields, either unilateral or bilateral in the lung lobes, but bilateral lung involvement (8/12) was more common. The lesions included nodules, masses, thick or thin wall cavities, or infiltrates. (3) Multiple biopsies for histologic study were done in 14 patients.
Wegener's granulomatosis has different radiographic manifestations and is difficult to differentiate from pulmonary abscess, tuberculosis, pneumonia or lung cancer. Repeated and multiple biopsies are essential to confirm the diagnosis.
研究肺韦格纳肉芽肿的临床特征。
回顾性分析过去20年中确诊的20例韦格纳肉芽肿患者的数据。
(1)12例(60%)韦格纳肉芽肿患者出现呼吸系统症状,包括咳嗽、脓痰、血痰、咯血或呼吸困难。其中5例患者以肺部症状为首发表现。(2)胸部X线检查显示,韦格纳肉芽肿可累及多个肺野,可单侧或双侧肺叶受累,但双侧肺受累(8/12)更为常见。病变包括结节、肿块、厚壁或薄壁空洞或浸润影。(3)14例患者进行了多次组织学活检。
韦格纳肉芽肿有不同的影像学表现,难以与肺脓肿、肺结核、肺炎或肺癌相鉴别。反复多次活检对于确诊至关重要。