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[间质性肺疾病的新分类]

[New classification of interstitial lung disease].

作者信息

Capron Frédérique

机构信息

Service d'Anatomie et Cytologie Pathologiques 1, Hôpital de la Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75651 Paris Cedex 13.

出版信息

Rev Pneumol Clin. 2005 Jun;61(3):133-40. doi: 10.1016/s0761-8417(05)84804-7.

Abstract

The pathological classification of interstitial lung disease (ILD) includes two general groups, diffuse infiltrative pneumonia with a specific histological presentation due to primary disease of unknown or unrecognized cause and idiopathic ILD. Diagnosis is established on the basis of clinical, radiological and pathological findings. In the first group of diffuse infiltrative pneumonia, the diagnosis is usually straightforward, established on endoscopic biopsy, alveolar lavage or surgical material depending on the case. The pathological classification of idiopathic ILD requires a surgical specimen. The entities redefined by the American Thoracic Society and the European Respiratory Society (ATS/ERS) are: usual interstitial pneumonia, non specific interstitial pneumonia, chronic organized pneumonia, diffuse alveolar damage, desquamative interstitial pneumonia, desquamative interstitial pneumonia with respiratory bronchiolitis and lymphocytic interstitial pneumonia. The diagnosis of idiopathic pulmonary fibrosis is established in a precise clinical and radiological context with an aspect of common interstitial pneumonia of the biopsy material. It is important to recognized common interstitial pneumonia because of the severe prognosis and to distinguish it from non-specific ILD.

摘要

间质性肺疾病(ILD)的病理分类包括两大类,一类是病因不明或未被认识的原发性疾病导致的具有特定组织学表现的弥漫性浸润性肺炎,另一类是特发性ILD。诊断基于临床、影像学和病理检查结果。在第一类弥漫性浸润性肺炎中,诊断通常较为直接,根据具体病例通过内镜活检、肺泡灌洗或手术取材来确定。特发性ILD的病理分类需要手术标本。美国胸科学会和欧洲呼吸学会(ATS/ERS)重新定义的类型有:普通型间质性肺炎、非特异性间质性肺炎、慢性机化性肺炎、弥漫性肺泡损伤、脱屑性间质性肺炎、合并呼吸性细支气管炎的脱屑性间质性肺炎和淋巴细胞性间质性肺炎。特发性肺纤维化的诊断是在精确的临床和影像学背景下,结合活检材料呈现普通型间质性肺炎的表现而确立的。认识普通型间质性肺炎很重要,因为其预后严重,且要将其与非特异性ILD区分开来。

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