经支气管肺冷冻活检在特发性急性纤维蛋白性和机化性肺炎中的应用

Shintani Ryota, Oda Tsuneyuki, Niwa Takashi, Sekine Akimasa, Hagiwara Eri, Okudela Koji, Takemura Tamiko, Ogura Takashi

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.

Department of Pathobiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Respir Med Case Rep. 2019 Jun 18;28:100888. doi: 10.1016/j.rmcr.2019.100888. eCollection 2019.

A 53-year-old Japanese female was admitted to our hospital with 3-week history of cough and worsening dyspnea. Chest computed tomography revealed unilateral focal consolidation in the right lower lobe. She underwent transbronchial lung cryobiopsy (TBLC) and histology showed acute fibrinous and organizing pneumonia (AFOP). High-dose methylprednisolone treatment improved her respiratory condition and radiological findings. AFOP is a rare histologic interstitial pneumonia pattern and has been diagnosed by surgical lung biopsy or autopsy in most cases. To our knowledge, this is the first detailed report of AFOP diagnosed by TBLC. TBLC can be performed safely with less invasion and be a useful diagnostic technique for rapidly progressive diffuse lung disease such as AFOP.

一名53岁的日本女性因咳嗽3周且呼吸困难加重入住我院。胸部计算机断层扫描显示右下叶单侧局灶性实变。她接受了经支气管肺冷冻活检（TBLC），组织学检查显示为急性纤维蛋白性和机化性肺炎（AFOP）。大剂量甲基强的松龙治疗改善了她的呼吸状况和影像学表现。AFOP是一种罕见的组织学间质性肺炎类型，大多数病例通过外科肺活检或尸检诊断。据我们所知，这是第一份通过TBLC诊断AFOP的详细报告。TBLC可以安全地进行，侵袭性较小，对于AFOP等快速进展的弥漫性肺疾病是一种有用的诊断技术。