Chino M, Yagi H, Kohno J, Hirose Y, Fukushima M, Okubo S, Fujii T, Kobayashi T, Handa K, Kusama S
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Feb;28(2):356-61.
A 41-year-old man was admitted to our hospital because of hemoptysis and dyspnea. Physical examination disclosed oral ulcer, acne and scrotal ulcer. Although ocular lesions were absent, the needle reaction was positive. Then we diagnosed this case as incomplete type of Behçet's disease. Chest X-ray showed diffuse retinolinear shadows in the entire lung field and an infiltrative shadow in the left middle lung field. CT-scan revealed interstitial shadows in the entire lung field, a wedge-shaped shadow in left S6 and aneurysmic dilatation of the left lower lobe pulmonary artery. Pulmonary angiography showed obstruction and aneurysmic dilatation of the left lower lobe pulmonary artery. Pathological examination of the TBLB specimen revealed thickening of the vessel wall, perivascular infiltrations of mononuclear cells, hemorrhage and slight thickening of alveolar septae. These findings were compatible with pulmonary lesions of Behçet's disease. After administration of corticosteroid, the symptoms and the chest roentgenographic findings improved. Pulmonary lesions of Behçet's disease were discussed.
一名41岁男性因咯血和呼吸困难入院。体格检查发现口腔溃疡、痤疮和阴囊溃疡。虽然眼部病变未出现,但针刺反应呈阳性。于是我们将该病例诊断为不完全型白塞病。胸部X线显示全肺野弥漫性网状阴影及左中肺野浸润性阴影。CT扫描显示全肺野间质阴影、左S6楔形阴影及左下叶肺动脉瘤样扩张。肺血管造影显示左下叶肺动脉阻塞及瘤样扩张。经支气管肺活检标本的病理检查显示血管壁增厚、单核细胞血管周围浸润、出血及肺泡间隔轻度增厚。这些发现符合白塞病的肺部病变。给予糖皮质激素治疗后,症状及胸部X线表现有所改善。对白塞病的肺部病变进行了讨论。