Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Second Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China.
J Int Med Res. 2020 Apr;48(4):300060520920068. doi: 10.1177/0300060520920068.
A 70-year-old man presented to our hospital because of a cough with bright red blood for 1 month. A chest computed tomography (CT) scan showed that there was a patchy, dense shadow below the pleura of the upper lobe of the left lung. This shadow was approximately 2.7 × 2.2 cm in size, with rough edges, adjacent pleural traction, and localized thickening. Percutaneous pulmonary needle biopsy was performed under CT guidance. Morphological features were characterized by multifocal centrilobular distribution of fibromyxoid polyps of granulation tissue in the lumen of distal airspaces and small bronchioles. These findings supported the diagnosis of focal cryptogenic organizing pneumonia. The patient was then treated with ceftazidime and prednisone. After this treatment, the patient visited the clinic and complete resolution of his respiratory symptoms and nearly complete resolution of the mass on chest CT were observed. The findings in our case provide clinical experience to help with the diagnosis of cryptogenic organizing pneumonia, which is difficult to diagnose.
一位 70 岁男性因咳嗽伴鲜红色血 1 个月就诊于我院。胸部 CT 扫描显示左肺上叶胸膜下有斑片状、致密影。该阴影大小约为 2.7×2.2cm,边缘粗糙,伴有邻近胸膜牵拉,局部增厚。在 CT 引导下行经皮肺穿刺活检。形态学特征表现为多发于小叶中心分布的纤维黏液样息肉样肉芽组织,位于远端气腔和小细支气管的管腔中。这些发现支持局灶性特发性机化性肺炎的诊断。随后,患者接受头孢他啶和泼尼松治疗。治疗后,患者来诊,呼吸症状完全缓解,胸部 CT 上的肿块几乎完全消失。我们的病例结果为诊断特发性机化性肺炎提供了临床经验,该疾病诊断困难。