Department of Pathology, The Mount Sinai Medical Center, New York, New York 10029, USA.
Arch Pathol Lab Med. 2010 May;134(5):719-27. doi: 10.5858/134.5.719.
Acute lung injury and acute respiratory distress syndrome are significant causes of pulmonary morbidity and are frequently fatal. These 2 entities have precise definitions from a clinical standpoint. Histologically, cases from patients with clinical acute lung injury typically exhibit diffuse alveolar damage, but other histologic patterns may occasionally be encountered such as acute fibrinous and organizing pneumonia, acute eosinophilic pneumonia, and diffuse hemorrhage with capillaritis.
To review the diagnostic criteria for various histologic patterns associated with a clinical presentation of acute lung injury and to provide diagnostic aids and discuss the differential diagnosis.
The review is drawn from pertinent peer-reviewed literature and the author's personal experience.
Acute lung injury remains a significant cause of morbidity and mortality. The pathologist should be aware of histologic patterns of lung disease other than diffuse alveolar damage, which are associated with a clinical presentation of acute lung injury. Identification of these alternative histologic findings, as well as identification of potential etiologic agents, especially infection, may impact patient treatment and disease outcome.
急性肺损伤和急性呼吸窘迫综合征是肺部发病率高且常致命的重要原因。这两种疾病从临床角度来看都有明确的定义。从组织学角度来看，临床诊断为急性肺损伤的患者的病例通常表现为弥漫性肺泡损伤，但偶尔也会遇到其他组织学模式，如急性纤维蛋白性和机化性肺炎、急性嗜酸性肺炎和弥漫性出血伴毛细血管炎。
回顾与急性肺损伤临床表现相关的各种组织学模式的诊断标准，并提供诊断辅助工具和讨论鉴别诊断。
综述内容源自相关的同行评议文献和作者的个人经验。
急性肺损伤仍然是发病率和死亡率的重要原因。病理学家应该了解弥漫性肺泡损伤以外的其他肺部疾病的组织学模式，这些模式与急性肺损伤的临床表现有关。识别这些替代的组织学发现，以及识别潜在的病因，特别是感染，可能会影响患者的治疗和疾病结局。
