Okuno Keiko, Kobayashi Kazuyuki, Kotani Yoshikazu, Ohnishi Hisashi, Ohbayashi Chiho, Nishimura Yoshihiro
Department of Internal Medicine, Kasai Municipal Hospital, Kasai, Japan.
Intern Med. 2010;49(12):1185-9. doi: 10.2169/internalmedicine.49.3049. Epub 2010 Jun 15.
A 42-year-old man was admitted to our hospital because of exertional dyspnea. He had worked as a metal grinder for 3 years, but had quit his job 1 month before admission. Chest radiography and high-resolution computed tomography showed diffuse ground-glass opacities like hypersensitivity pneumonitis shadows. The results of high-energy dispersion X-ray microanalysis indicated that the patient had hard metal pneumoconiosis associated with tungsten. Since the histological changes distributed terminal to respiratory bronchiole and surrounding alveoli, and macrophages engulfed black granules within the alveoli, in absence of giant cells, we considered this case to be a type of hypersensitivity pneumonitis of hard metal lung.
一名42岁男性因劳力性呼吸困难入院。他曾做过3年金属研磨工，但在入院前1个月辞职。胸部X线摄影和高分辨率计算机断层扫描显示出弥漫性磨玻璃影，类似过敏性肺炎阴影。高能色散X射线微分析结果表明，该患者患有与钨相关的硬金属尘肺。由于组织学改变分布于呼吸细支气管末端及周围肺泡，且肺泡内巨噬细胞吞噬黑色颗粒，未见巨细胞，我们认为该病例属于硬金属肺的一种过敏性肺炎类型。
