Westhoff M, Welim B, Müller K-M
Pneumologische Klinik, Lungenklinik Hemer, Hemer.
Pneumologie. 2005 Nov;59(11):804-10. doi: 10.1055/s-2005-915590.
Bronchocentric granulomatosis is a rare disease, which has to be taken into consideration in the differential diagnostic of pulmonary nodules and tumors. Two cases are presented, in which only open lung biopsy made it possible to get the diagnosis of bronchocentric granulomatosis. A 78-year-old woman presented with multiple small pulmonary nodules with aspergillus colonization, whereas an 83-year-old man presented with a large mass in the left upper lobe. Corticosteroid therapy led to sustained remission in both patients. The case reports will underline that bronchocentric granulomatosis is not a uniform clinical entity, but has variable clinical and radiological appearances. Its former subdivision into two forms differing by the occurrence of asthma with the coexistence of an aspergillus colonization, does not represent the many different manifestations. Until now the etiology of bronchocentric granulomatosis is uncertain. But there are hints, that the granulomatous inflammation might be the uniform response to different causes. The definite diagnosis of bronchocentric granulomatosis can only be made histologically. This mostly requires surgical lung biopsy. With therapy -- either surgery or corticosteroid therapy or the combination of both -- the prognosis is good.
支气管中心性肉芽肿病是一种罕见疾病，在肺结节和肿瘤的鉴别诊断中必须予以考虑。本文报告两例病例，仅通过开胸肺活检才得以诊断支气管中心性肉芽肿病。一名78岁女性表现为多个伴有曲霉菌定植的小肺结节，而一名83岁男性表现为左上叶的一个大肿块。皮质类固醇治疗使两名患者均获得持续缓解。病例报告将强调支气管中心性肉芽肿病并非一种统一的临床实体，而是具有多样的临床和影像学表现。其先前根据是否伴有哮喘及曲霉菌定植分为两种类型的分类方式，并不能涵盖其众多不同表现。迄今为止，支气管中心性肉芽肿病的病因尚不确定。但有迹象表明，肉芽肿性炎症可能是对不同病因的一种统一反应。支气管中心性肉芽肿病的明确诊断只能通过组织学检查做出。这大多需要外科肺活检。通过治疗——手术、皮质类固醇治疗或两者联合——预后良好。
