Kawaguchi Takako, Oda Keishi, Kido Takashi, Kawanami Toshinori, Kawabata Yoshinori, Yatera Kazuhiro
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Japan.
Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, Japan.
Intern Med. 2018 Jan 1;57(1):85-89. doi: 10.2169/internalmedicine.9187-17. Epub 2017 Oct 16.
Although the majority of patients with Mycobacterium tuberculosis have pulmonary involvement, some cases have pleural involvement as extra-pulmonary sites of infection. We herein report a case of upper lobe-predominant pulmonary fibrosis that developed in a 47-year-old male with a history of bilateral tuberculous pleurisy. Based on his chest radiological findings, pleuroparenchymal fibroelastosis (PPFE) was most strongly suspected, and a surgical lung biopsy (SLB) was performed to obtain a pathological diagnosis. The SLB specimens showed interstitial pneumonia with pleural involvement without any characteristic findings of PPFE. Careful discretion in obtaining a precise diagnosis of this condition should be practiced in such cases.
虽然大多数肺结核患者有肺部受累，但有些病例有胸膜受累作为肺外感染部位。我们在此报告一例以双上肺为主的肺纤维化病例，该病例发生在一名有双侧结核性胸膜炎病史的47岁男性身上。根据其胸部影像学表现，最强烈怀疑为胸膜实质纤维弹性组织增生症（PPFE），并进行了外科肺活检（SLB）以获得病理诊断。SLB标本显示有胸膜受累的间质性肺炎，无PPFE的任何特征性表现。在此类病例中，应谨慎判断以准确诊断这种情况。
