Cottin V, Loire R, Chalabreysse L, Thivolet F, Cordier J F
Service de Pneumologie, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Université Claude Bernard, Lyon, France.
Rev Mal Respir. 2001 Feb;18(1):25-33.
Nonspecific interstitial pneumonitis with fibrosis has been individualized within the group of idiopathic diffuse interstitial pneumonias by pathological criteria. It is differentiated from usual interstitial pneumonitis by the temporal uniformity of the lesions, a prominent inflammatory interstitial infiltration, and the absence of honeycombing. Clinical and functional symptoms are those of diffuse interstitial pneumonitis. An etiology may be found in about half the cases, including connective tissue disease, exposure to organic antigens, or recent acute lung injury. Computed tomography of the chest shows bilateral ground glass opacities, and alveolar opacities with a peribronchiolar or patchy distribution. Prognosis is rather good, since a majority of patients improve when treated with corticosteroids or with an association of corticosteroids and immunosuppressive drugs. These etiologic and prognostic features justify the individualization of nonspecific interstitial pneumonitis with fibrosis as a distinct clinicopathological entity.
伴纤维化的非特异性间质性肺炎已根据病理标准在特发性弥漫性间质性肺炎组中被个体化。它与寻常型间质性肺炎的区别在于病变的时间一致性、显著的炎症性间质浸润以及无蜂窝状改变。临床和功能症状为弥漫性间质性肺炎的症状。约半数病例可找到病因,包括结缔组织病、接触有机抗原或近期急性肺损伤。胸部计算机断层扫描显示双侧磨玻璃影,以及沿支气管周围或斑片状分布的肺泡实变影。预后相当良好,因为大多数患者接受皮质类固醇或皮质类固醇与免疫抑制药物联合治疗后病情改善。这些病因和预后特征证明将伴纤维化的非特异性间质性肺炎作为一种独特的临床病理实体进行个体化是合理的。