Sawahata Michiru, Shijubo Noriharu, Johkoh Takeshi, Hagiwara Koichi, Konno Satoshi, Yamaguchi Tetsuo
Division of Pulmonary Medicine, Department of Medicine Jichi Medical University Shimotsuke Japan.
Department of Respiratory Medicine JR Sapporo Hospital Sapporo Japan.
Respirol Case Rep. 2020 Mar 8;8(3):e00539. doi: 10.1002/rcr2.539. eCollection 2020 Apr.
Gene expression profiles of patients with progressive sarcoidosis, most of whom had evidence of fibrosis on imaging, have been reported to be similar to those of patients with inflammatory hypersensitivity pneumonitis, while expression profiles in progressive sarcoidosis did not resemble those of idiopathic pulmonary fibrosis. However, it is not known whether specific parenchymal features discerned on computed tomography (CT) imaging can predict development of fibrosis in pulmonary fibrosis. We herein describe a rare case of pulmonary sarcoidosis with honeycomb lung-like structures developing as a result of concentration of traction bronchiectasis distally, predominantly in both lower lung fields, which developed through shrinkage of consolidations comprising a "central-peripheral band" detected in a woman in her 60s, with non-caseating epithelioid granuloma. To our knowledge, this is the first case demonstrating the distinctive morphology and developmental process of honeycomb lung-like structures in fibrotic pulmonary sarcoidosis.
据报道，进行性结节病患者的基因表达谱与炎症性过敏性肺炎患者相似，其中大多数患者在影像学上有纤维化证据，而进行性结节病的表达谱与特发性肺纤维化患者不同。然而，尚不清楚计算机断层扫描（CT）成像中发现的特定实质特征是否能预测肺纤维化中纤维化的发展。我们在此描述了一例罕见的肺结节病病例，其出现蜂窝肺样结构是由于远端牵引性支气管扩张集中所致，主要位于双下肺野，该病例发生于一名60多岁女性，其肺内存在由“中央-外周带”组成的实变灶，经收缩后形成，伴有非干酪样上皮样肉芽肿。据我们所知，这是首例展示纤维化性肺结节病中蜂窝肺样结构独特形态和发展过程的病例。
