Nagata N, Sueishi K, Tanaka K, Iwata Y
Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Surg Pathol. 1990 May;14(5):485-8. doi: 10.1097/00000478-199005000-00009.
A 56-year-old Japanese man without asthma was admitted with cough, excessive sputum, and abnormalities on the chest X-ray film. The lung biopsy material showed necrotizing granulomas centered upon bronchioles. Serial sections of the material revealed a mass of well-oriented, uniform, viable-appearing aspergillus hyphae in the center of the granulomas. There was no evidence of blood eosinophilia, tissue infiltration of eosinophils, or deposition of immunoglobulins or complement in the granulomatous lesion. Thus, we obtained no direct evidence of an allergic reaction. After treatment with the antifungal drug, 5-flucytosine, the patient is in good health. This may be the first documentation of pulmonary aspergillosis showing predominantly bronchocentric granulomas in a nonasthmatic patient who was not immunocompromised.
一名56岁无哮喘病史的日本男性因咳嗽、咳痰过多及胸部X光片异常入院。肺活检材料显示以细支气管为中心的坏死性肉芽肿。该材料的连续切片显示在肉芽肿中心有一团排列良好、形态均匀、看似存活的曲霉菌丝。没有血液嗜酸性粒细胞增多、嗜酸性粒细胞组织浸润或肉芽肿病变中免疫球蛋白或补体沉积的证据。因此，我们没有获得过敏反应的直接证据。在用抗真菌药物5-氟胞嘧啶治疗后，患者健康状况良好。这可能是首例关于在非免疫功能低下的非哮喘患者中以支气管中心性肉芽肿为主的肺曲霉病的记录。
