Hara Johsuke, Nishi Kouichi, Demura Yoshiki, Kurokawa Kohji, Kurumaya Hiroshi, Katayanagi Kazuyoshi, Kasahara Kazuo, Fujimura Masaki, Nakao Shinji
*Department of Respiratory Medicine †Department of Pathology, Ishikawa Prefectural Central Hospital ‡Department of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan.
J Bronchology Interv Pulmonol. 2011 Jul;18(3):285-7. doi: 10.1097/LBR.0b013e318222a05d.
We report here a case of chronic eosinophilic pneumonia with significant endobronchial involvement. A 59-year-old man was admitted complaining of fever, productive cough, wheezing, and dyspnea. There were ground-glass opacities in bilateral upper fields and tram track shadows in the left lower lung field on chest x-ray, and ground-glass opacities in bilateral upper lobes, thickening of the bronchial walls, and centrilobular nodules on computed tomographic scan of the chest. There was marked eosinophilia in the peripheral blood and bronchoalveolar lavage fluid and was diagnosed as chronic eosinophilic pneumonia. Bronchoscopy also revealed white nodules at the orifice of the right S and the left S bronchi. The histologic examination of these nodules revealed eosinophilic inflammation into the bronchial wall. This is a rare case of chronic eosinophilic pneumonia with endobronchial eosinophilic involvement.
我们在此报告一例伴有显著支气管内受累的慢性嗜酸性粒细胞性肺炎病例。一名59岁男性因发热、咳痰、喘息和呼吸困难入院。胸部X线显示双侧上肺野有磨玻璃影,左下肺野有轨道征,胸部计算机断层扫描显示双侧上叶有磨玻璃影、支气管壁增厚和小叶中心结节。外周血和支气管肺泡灌洗液中有明显的嗜酸性粒细胞增多,被诊断为慢性嗜酸性粒细胞性肺炎。支气管镜检查还发现右S和左S支气管开口处有白色结节。这些结节的组织学检查显示支气管壁有嗜酸性粒细胞炎症。这是一例罕见的伴有支气管内嗜酸性粒细胞受累的慢性嗜酸性粒细胞性肺炎病例。