Nagata N, Kawarada Y, Takayama K, Shigematsu N, Ishibashi T
Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kekkaku. 1990 Jul;65(7):465-70.
To determine whether or not patients who showed abundant lymphocytes in pleural effusion without any specific findings by pleural biopsy could be histopathologically differentiated between those with tuberculous and nontuberculous origin, we reexamined histology of pleural biopsies of all patients whose pleural effusion showed predominantly lymphocytes and did not contain malignant cells from January, 1984 to March, 1989. A total of 45 patients with a nonspecific histology of pleural biopsy were categorized based on their final diagnosis into three groups; tuberculous (n = 20), carcinomatous (n = 10) and nontuberculous, benign pleurisy (n = 15). Pleural biopsy of patients with nontuberculous, benign pleurisy frequently showed band-like infiltration of mononuclear cells in the subpleural adipose tissue (11 out of 15 patients), while the finding was significantly less frequent in those with tuberculous pleurisy (1 out of 20, p less than 0.01) and pleurisy associated with carcinoma (3 out of 10, p less than 0.05). Based on these findings, the presence of band-like infiltration of mononuclear cells in the subpleural adipose tissue in pleural biopsy of patients with abundant lymphocytes in pleural effusion strongly suggests that the pleurisy is nontuberculous origin.
为了确定胸腔积液中淋巴细胞丰富但经胸膜活检无任何特异性发现的患者在组织病理学上能否区分结核性和非结核性病因，我们重新检查了1984年1月至1989年3月期间所有胸腔积液以淋巴细胞为主且不含恶性细胞的患者的胸膜活检组织学。共有45例胸膜活检组织学无特异性的患者根据最终诊断分为三组：结核性（n = 20）、癌性（n = 10）和非结核性良性胸膜炎（n = 15）。非结核性良性胸膜炎患者的胸膜活检常显示胸膜下脂肪组织中有单核细胞带状浸润（15例患者中有11例），而结核性胸膜炎患者（20例中有1例，p<0.01）和癌性胸膜炎患者（10例中有3例，p<0.05）中该发现的频率明显较低。基于这些发现，胸腔积液淋巴细胞丰富的患者胸膜活检中胸膜下脂肪组织存在单核细胞带状浸润强烈提示胸膜炎为非结核性病因。
