Haraguchi Tetsuro, Tashiro Hiroki, Takahashi Koichiro, Kurihara Yuki, Sadamatsu Hironori, Miyahara Naofumi, Hiratsuka Masafumi, Kimura Shinya, Sueoka-Aragane Naoko
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University Hospital, Saga, Japan.
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga University Hospital, Saga, Japan.
Respir Med Case Rep. 2021 May 20;33:101430. doi: 10.1016/j.rmcr.2021.101430. eCollection 2021.
A 37-year-old man with fever, cough, and dyspnea with no medical history developed an eosinophilic pleural effusion and blood eosinophilia. No evidence of malignancy or pathogens was detected in the pleural effusion, and the pleural specimen obtained by thoracoscopy showed eosinophilic infiltration with inflammatory granulation tissue without fibrinoid necrosis or malignant cells. Since a myeloproliferative disorder was also excluded, the diagnosis was idiopathic eosinophilic pleurisy. Corticosteroid treatment was started and then slowly tapered, and the eosinophilic pleural effusion resolved. Considering the various etiologies of eosinophilic pleurisy, a practical clinical approach to the investigation and diagnosis of eosinophilic pleurisy is presented.
一名37岁男性，无病史，出现发热、咳嗽和呼吸困难，伴有嗜酸性胸腔积液和血液嗜酸性粒细胞增多。胸腔积液中未检测到恶性肿瘤或病原体的证据，经胸腔镜获取的胸膜标本显示嗜酸性粒细胞浸润，伴有炎性肉芽组织，无纤维蛋白样坏死或恶性细胞。由于也排除了骨髓增殖性疾病，诊断为特发性嗜酸性胸膜炎。开始使用皮质类固醇治疗，然后缓慢减量，嗜酸性胸腔积液消退。考虑到嗜酸性胸膜炎的各种病因，本文介绍了一种针对嗜酸性胸膜炎调查和诊断的实用临床方法。
