Schreiber Tina, Hagmeyer Lars, Randerath Winfried J
Dtsch Med Wochenschr. 2021 Oct;146(21):1392-1398. doi: 10.1055/a-1275-6734. Epub 2021 Oct 20.
Hypersensitivity pneumonitis (HP) is an inflammatory and/or fibrotic disease of the lung parenchyma and terminal bronchioles caused by an allergic reaction to inhaled antigens. The immune response following antigen exposure results in lymphocytic inflammation as well as granuloma formation.The typical histologic pattern of HP consists of cellular interstitial pneumonia, cellular bronchiolitis, and epithelioid cell granulomas. The additional presence of fibrosis has a significant impact on the course as well as the prognosis of the disease and represents a therapeutic approach. Therefore, a classification into a non-fibrotic and a fibrotic phenotype is proposed.The diagnosis of HP is made by high-resolution computed tomography (HRCT) of the lung, evaluation of possible antigen exposure, and bronchoscopy with bronchoalveolar lavage and, if necessary, forceps biopsy. If the diagnosis is inconclusive, transbronchial cryobiopsy or surgical lung biopsy may need to follow. A multidisciplinary board is critical in making the diagnosis.
过敏性肺炎（HP）是一种由吸入抗原的过敏反应引起的肺实质和终末细支气管的炎症性和/或纤维化疾病。抗原暴露后的免疫反应导致淋巴细胞炎症以及肉芽肿形成。HP的典型组织学模式包括细胞性间质性肺炎、细胞性细支气管炎和上皮样细胞肉芽肿。纤维化的额外存在对疾病的进程和预后有重大影响，并代表一种治疗方法。因此，建议将其分为非纤维化和纤维化表型。HP的诊断通过肺部高分辨率计算机断层扫描（HRCT）进行，评估可能的抗原暴露情况，并进行支气管镜检查及支气管肺泡灌洗，必要时进行钳取活检。如果诊断不明确，可能需要进行经支气管冷冻活检或外科肺活检。多学科委员会对于做出诊断至关重要。
