Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
BMJ Case Rep. 2022 Aug 1;15(8):e249998. doi: 10.1136/bcr-2022-249998.
A man in his 60s exhibited persistent dry cough and dyspnoea, which persisted even after smoking cessation. Chest high-resolution CT showed diffuse ground-glass opacities in the subpleural areas of both lungs. He underwent bronchoscopy, but no definitive diagnosis could be made. Histopathological analysis of the specimen obtained by surgical lung biopsy showed a desquamative interstitial pneumonia (DIP) pattern, with lymphocyte and plasma cell infiltrates in the alveolar septa; the ratio of IgG and IgG4-positive cells was more than 90%. He quit smoking, but the radiological findings worsened. Based on the pathological findings, we diagnosed the patient with DIP due to IgG4-related lung disease. Prednisolone was initiated, and the symptoms and radiological findings improved.
一位 60 多岁的男性患者表现出持续的干性咳嗽和呼吸困难，即使戒烟后仍持续存在。胸部高分辨率 CT 显示双肺胸膜下区弥漫性磨玻璃影。他接受了支气管镜检查，但未能明确诊断。手术肺活检获得的标本的组织病理学分析显示出脱屑性间质性肺炎（DIP）模式，肺泡隔中有淋巴细胞和浆细胞浸润；IgG 和 IgG4 阳性细胞的比例超过 90%。他戒烟了，但影像学结果恶化了。根据病理发现，我们诊断该患者患有 IgG4 相关肺疾病引起的 DIP。开始使用泼尼松龙治疗，症状和影像学发现得到改善。
