Department of Respiratory Medicine, Saitama Red Cross Hospital, Japan.
Department of Respiratory Medicine, Tokyo Jikei University Hospital, Japan.
Intern Med. 2021 May 1;60(9):1457-1462. doi: 10.2169/internalmedicine.6028-20. Epub 2020 Dec 7.
We herein report four cases of diffuse bronchiolitis proven by a transbronchial lung cryobiopsy (TBLC). Based on various aspects, including the pathological findings, we definitively diagnosed two patients with diffuse panbronchiolitis (DPB) and the other two with primary ciliary dyskinesia (PCD). One of the DPB patients had more severe peribronchiolar fibrosis than the other, and the disease course was refractory to macrolide therapy. One of the PCD patients was additionally diagnosed with combined constrictive bronchiolitis. This report highlights the importance of a TBLC in the differentiation of bronchiolitis, suggesting its utility for helping pulmonologists formulate a treatment strategy.
我们在此报告了 4 例经经支气管肺冷冻活检(TBLC)证实的弥漫性细支气管炎病例。基于包括病理学发现在内的各个方面,我们明确诊断了 2 例弥漫性泛细支气管炎(DPB)和 2 例原发性纤毛运动障碍(PCD)。其中一位 DPB 患者的支气管周围纤维化比另一位更严重,且疾病对大环内酯类药物治疗有抗性。其中一位 PCD 患者还被诊断为合并性缩窄性细支气管炎。本报告强调了 TBLC 在细支气管炎鉴别诊断中的重要性,提示其可帮助肺病学家制定治疗策略。