Lepekha L N, Burtseva S A, Evgushchenko G V
Voen Med Zh. 2012 Mar;333(3):24-9.
Differential diagnosis of disseminated lung diseases, particularly tuberculosis and sarcoidosis, presents certain difficulties for clinicians. In the verification of the diagnosis a decisive role belongs to the morphological study, for which the most commonly used material is transbronchial biopsy. Diagnostic signs of active disseminated pulmonary tuberculosis are presence of different-sized granulomas with signs merger, necrosis, infiltration of polymorphonuclear leukocytes, weakly expressed fibrillogenesis. Cytological markers of a specific process are young biosinteziruyuschie macrophages and acid-fast bacilli. The diagnostic features of pulmonary sarcoidosis are monomorphic granulomas with no tendency to merge and necrotisation expressed fibrosis and hyalinization processes. Cytological marker for the disease is the high content of epithelioid cells with signs of secretion.
弥漫性肺部疾病的鉴别诊断，尤其是肺结核和结节病，给临床医生带来了一定困难。在诊断的核实中，形态学研究起着决定性作用，为此最常用的材料是经支气管活检。活动性弥漫性肺结核的诊断标志是存在大小不同的肉芽肿，伴有融合、坏死、多形核白细胞浸润、纤维形成微弱等迹象。特定过程的细胞学标志物是年轻的生物合成巨噬细胞和抗酸杆菌。肺结节病的诊断特征是单一形态的肉芽肿，无融合和坏死倾向，有明显的纤维化和透明变性过程。该疾病的细胞学标志物是上皮样细胞含量高且有分泌迹象。
