Eum Seok-Yong, Kong Ji-Hye, Jeon Bo-Young, Cho Sang-Nae, Kim Jhingook, Via Laura E, Barry Iii Clifton E, Koh Won-Jung
Division of Immunopathology and Cellular Immunology, International Tuberculosis Research Center, Masan, Republic of Korea.
J Med Case Rep. 2010 May 26;4:156. doi: 10.1186/1752-1947-4-156.
Pulmonary ossification has been rarely observed in pulmonary fibrosis and in some chronic respiratory diseases such as chronic obstructive pulmonary disease. We report here a metaplastic ossification in the bronchial cartilage of a patient with multi-drug resistant tuberculosis.
We report the case of a 41-year-old Asian man from Korea with chronic multi-drug resistant tuberculosis with a rare focus of bone formation from the cartilage of a bronchus subtending an active cavity. The patient had a large multi-lobed, thick-walled cavitary tuberculosis lesion in his left upper lobe. Severe infiltration of his lymphocytes and epithelioid cells, along with some giant cells and neutrophils, was observed in the patient's bronchial wall. Desquamated bronchial epithelium and acid-fast bacilli were found inside his bronchus. A small focus of bony metaplasia was found in the cartilage of his bronchial wall. Histopathological examination confirmed calcification and showed hematopoietic cells forming in his marrow cavity.
Chronic inflammation in the lungs of our patient, caused by underlying tuberculosis, probably played a role in the development of osseous metaplasia from the associated cartilage of the bronchial wall.
肺骨化在肺纤维化及一些慢性呼吸道疾病如慢性阻塞性肺疾病中很少见。我们在此报告一例耐多药结核病患者支气管软骨中的化生骨化。
我们报告一例来自韩国的41岁亚洲男性，患有慢性耐多药结核病，在一个活动性空洞周围的支气管软骨处有罕见的骨形成灶。患者左上叶有一个多叶、厚壁的空洞性结核病灶。在患者支气管壁观察到淋巴细胞和上皮样细胞严重浸润，伴有一些巨细胞和中性粒细胞。在支气管内发现了脱落的支气管上皮和抗酸杆菌。在支气管壁软骨中发现一个小的骨化生灶。组织病理学检查证实有钙化，并显示骨髓腔内有造血细胞形成。
我们患者肺部由潜在结核病引起的慢性炎症，可能在支气管壁相关软骨的骨化生发展中起了作用。
