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1例在免疫抑制患者中,因铜绿假单胞菌肺炎接受治疗后出现持续块状病变的局限性肺钙化病例。

A Case of Localized Pulmonary Calcification Presenting as a Persistent Mass Lesion in an Immunosuppressed Patient Following Treatment of a Pseudomonas Pneumonia.

作者信息

Cecchini Matthew J, Shepherd Dominic L, Shepherd Jessica G

机构信息

Department of Pathology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, CA.

Schulich School of Medicine & Dentistry, Western University, London, Ontario, CA.

出版信息

Cureus. 2017 Oct 11;9(10):e1765. doi: 10.7759/cureus.1765.

Abstract

We report a case of a persistent right upper lobe opacity following treatment for a infection in an immunosuppressed patient with a recent renal transplantation. The patient underwent a surgical lung biopsy for definitive diagnosis of the mass. The lesion was composed of extensive calcifications deposited throughout the lung with associated fibrosis. The patient had a history of a remote parathyroidectomy for hyperparathyroidism; however, the parathyroid hormone (PTH) and the calcium levels were still mildly elevated. No other calcified lung lesions had developed in a follow-up after the initial resection. Pulmonary calcification has been classically associated with varicella pneumonia; no viral cytopathic changes were identified for varicella or other viruses in this case. The calcification appears to be secondary to the recent pneumonia. To our knowledge, this is the first report of a pneumonia resulting in extensive localized pulmonary calcification. This is an important diagnostic consideration as this benign entity should be considered in patients with persistent opacities following treatment for pneumonia.

摘要

我们报告了一例近期接受肾移植的免疫抑制患者在治疗感染后右上叶持续存在不透明影的病例。该患者接受了手术肺活检以明确肿块的诊断。病变由遍布肺部的广泛钙化及相关纤维化组成。患者有因甲状旁腺功能亢进行既往甲状旁腺切除术的病史;然而,甲状旁腺激素(PTH)和钙水平仍轻度升高。初次切除后的随访中未出现其他钙化性肺病变。肺钙化传统上与水痘肺炎相关;该病例中未发现水痘或其他病毒的病毒细胞病变改变。钙化似乎继发于近期的肺炎。据我们所知,这是首例肺炎导致广泛局限性肺钙化的报告。这是一个重要的诊断考量因素,因为对于肺炎治疗后持续存在不透明影的患者应考虑这种良性病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3333/5724809/d8f404c14daa/cureus-0009-00000001765-i01.jpg

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