Miyazaki Hiroo, Gemma Hitoshi, Koshimizu Naoki, Sato Masaki, Uemura Keiichi, Tamura Ryoji, Neyatani Hiroshi, Suda Takafumi, Chida Kingo, Nakamura Hirotoshi
Department of Respiratory Disease, Fukuroi Municipal Hospital.
Nihon Kokyuki Gakkai Zasshi. 2004 Mar;42(3):277-83.
We report two cases of intralobar pulmonary sequestration associated with nontuberculous mycobacterial infection. Case 1: A 28-year-old woman was hospitalized because of cough. Chest CT demonstrated multi-cystic lesions with an air-fluid level in the right lower lobe. Case 2: A 25-year-old woman was hospitalized because of fever. Chest CT demonstrated homogeneous consolidation in the right lower lobe. In both cases, aortography showed an anomalous artery supplying the right basal segment, and pulmonary sequestration was diagnosed. Furthermore, Mycobacterium avium was detected in the bronchial lavage, and a right lower lung lobectomy was performed after chemotherapy. Mycobacterium avium was cultured from the fluid in the sequestrated lung, and histological findings of the resected lobe showed epithelioid cell granulomas. We diagnosed these cases as having pulmonary sequestrations associated with nontuberculous mycobacterial infection. We concluded that pulmonary sequestration should be considered an underlying disease of secondary nontuberculous mycobacterial infections in young patients.
我们报告两例与非结核分枝杆菌感染相关的叶内型肺隔离症病例。病例1:一名28岁女性因咳嗽入院。胸部CT显示右下叶有多囊性病变并伴有气液平面。病例2:一名25岁女性因发热入院。胸部CT显示右下叶均匀性实变。在这两个病例中,主动脉造影均显示有一条异常动脉供应右基底段,从而诊断为肺隔离症。此外,在支气管灌洗中检测到鸟分枝杆菌,化疗后行右下肺叶切除术。从隔离肺的液体中培养出鸟分枝杆菌,切除肺叶的组织学检查显示上皮样细胞肉芽肿。我们将这些病例诊断为与非结核分枝杆菌感染相关的肺隔离症。我们得出结论,在年轻患者中,肺隔离症应被视为继发性非结核分枝杆菌感染的潜在疾病。