Tetikkurt Cuneyt, Tetikkurt Seza, Ozdemir Imran, Bayar Nihal
Pulmonary Diseases Department, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
Multidiscip Respir Med. 2011 Jun 30;6(3):180-2. doi: 10.1186/2049-6958-6-3-180.
Round atelectasis is a benign inflammatory condition most frequently observed in patients with asbestos exposure but it can also result from a variety of chronic pleural diseases like infection. It has not previously been described in sarcoidosis. We report the occurrence of round atelectasis in four previously diagnosed sarcoidosis patients who were under follow up at our outpatient clinic. Three patients had symptoms consisting of thoracic pain, dry cough and sensation of fullness at the posterior thorax, respectively. Chest roentgenogram showed subpleural or pleural based opacity with diameters ranging from 2 to 3 cm in each of the patients. Chest computerized tomography (CT) revealed features of round atelectasis. Fiberoptic bronchoscopy with transbronchial lung biopsy was performed. Diagnosis was confirmed by the histopathologic examination of the biopsy samples. The mechanical influence of a prior pleural effusion due to sarcoidosis may be the predominant mechanism underlying the onset of round atelectasis in these patients. Clinicians should bear in mind the possibility of sarcoidosis as an etiologic factor for round atelectasis.
圆形肺不张是一种良性炎症性疾病,最常见于石棉暴露患者,但也可由多种慢性胸膜疾病(如感染)引起。此前尚未在结节病中描述过。我们报告了4例在我们门诊接受随访的先前诊断为结节病的患者中出现圆形肺不张的情况。3例患者分别有胸痛、干咳和后胸部胀满感等症状。胸部X线片显示每例患者均有直径为2至3厘米的胸膜下或胸膜旁混浊影。胸部计算机断层扫描(CT)显示圆形肺不张的特征。进行了纤维支气管镜检查及经支气管肺活检。活检样本的组织病理学检查证实了诊断。结节病所致先前胸腔积液的机械影响可能是这些患者发生圆形肺不张的主要机制。临床医生应牢记结节病作为圆形肺不张病因的可能性。