Imai H, Kitaichi M
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Jul;27(7):829-36.
The patient was a 57-year-old Japanese male with dry cough, exertional dyspnea of 6 weeks' duration and bilateral basal pulmonary infiltrates, before a left thoracotomy for lung biopsy was performed in August 1984. Because the symptoms of the patient were not severe, he could be followed up without corticosteroid hormone treatment for 3.5 years, during which a spontaneous regression of both symptoms and objective findings were recognized, following the open lung biopsy. The primary pathological diagnosis of the case was an unclassified type of interstitial pneumonia, because the two lobes of the left lung showed diffuse alveolar septal fibrotic and inflammatory changes. However, granulation tissues in respiratory bronchioles were noted in tissue from the lingular segment and, after more careful observation, from the lower lobe (segment 8) (Fig. 9). Bacteriological cultures from fresh lung tissues were negative for microorganisms. From these clinical and pathological findings, this patient's pulmonary lesions were determined to be idiopathic BOOP.
该患者为一名57岁的日本男性,干咳、劳力性呼吸困难持续6周,双肺基底出现浸润影,于1984年8月行左开胸肺活检。由于患者症状不严重,在未使用糖皮质激素治疗的情况下随访了3.5年,在此期间,开胸肺活检后症状和客观检查结果均出现自发缓解。该病例的主要病理诊断为未分类的间质性肺炎,因为左肺两叶显示弥漫性肺泡间隔纤维化和炎症改变。然而,在舌段组织以及经过更仔细观察后在下叶(8段)发现了呼吸性细支气管内的肉芽组织(图9)。新鲜肺组织的细菌培养未发现微生物。根据这些临床和病理结果,该患者的肺部病变被确定为特发性闭塞性细支气管炎伴机化性肺炎。