Hakala M, Pääkkö P, Huhti E, Tarkka M, Sutinen S
Department of Internal Medicine, University of Oulu, Finland.
Clin Rheumatol. 1990 Dec;9(4):452-60. doi: 10.1007/BF02030506.
In order to shed light on the histological changes occurring in the lungs of patients with rheumatoid arthritis (RA), we scrutinized an open lung biopsy file of 199 patients and selected the patients with RA. The histopathological patterns observed were: pulmonary rheumatoid nodules (4 cases, including one with rheumatoid pneumoconiosis); usual interstitial pneumonia (UIP) (2 cases); desquamative interstitial pneumonia (2 cases); bronchiolitis obliterans with patchy organizing pneumonia (2 cases); follicular bronchiolitis (1 case); organizing pneumonia always associated with bronchiolitis (3 cases); granulomatous reaction (3 cases); obliterating vasculitis (3 cases); granulomatous vasculitis (1 case); lymphoid hyperplasia (2 cases); and localized pulmonary fibrosis (1 case). The clinical data and laboratory findings for the histopathological groups overlapped and did not properly predict the anatomical picture. Both patients with UIP died of lung disease. Otherwise the prognosis in the series was good.
为了阐明类风湿关节炎（RA）患者肺部发生的组织学变化，我们仔细查阅了199例患者的开放性肺活检档案，并挑选出RA患者。观察到的组织病理学模式有：肺类风湿结节（4例，包括1例类风湿尘肺）；寻常型间质性肺炎（UIP）（2例）；脱屑性间质性肺炎（2例）；闭塞性细支气管炎伴斑片状机化性肺炎（2例）；滤泡性细支气管炎（1例）；总是与细支气管炎相关的机化性肺炎（3例）；肉芽肿反应（3例）；闭塞性血管炎（3例）；肉芽肿性血管炎（1例）；淋巴样增生（2例）；以及局限性肺纤维化（1例）。组织病理学分组的临床数据和实验室检查结果相互重叠，无法准确预测解剖学表现。两名UIP患者均死于肺部疾病。除此之外，该系列患者的预后良好。
