经支气管肺冷冻活检诊断弥漫性泛细支气管炎
Diagnosis of diffuse panbronchiolitis by transbronchial lung cryobiopsy.
作者信息
Ishii Satoru, Morishita Momoko, Matsuki Rei, Izumi Shinyu, Hojo Masayuki, Sugiyama Haruhito
机构信息
Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-Ku, Tokyo, 162-8655, Japan.
出版信息
Heliyon. 2023 Mar 31;9(4):e15127. doi: 10.1016/j.heliyon.2023.e15127. eCollection 2023 Apr.
A 70-year-old man began to cough. Chest X-ray showed a tumor in the center, pleural effusion on the left side, and diffuse granular shadows on the right side. Chest computed tomography (CT) showed bronchial wall thickening and numerous granular shadows. We suspected diffuse panbronchiolitis. Thus, transbronchial lung biopsy (TBLB) and transbronchial lung cryobiopsy (TBLC) were performed. The tissue size obtained was 1 mm by TBLB and 6 mm at 5 seconds by TBLC. Histological analysis of the TBLB specimen showed lymphocyte infiltration, no fibrosis in Hematoxylin-eosin (HE) staining, and no elastic fibers in Elastica van Gieson (EVG) staining. On the other hand, TBLC specimens showed inflammatory cell infiltration and fibrosis around the bronchioles in HE staining and hypertrophy of elastic fibers in EVG staining. It was diagnosed as diffuse panbronchiolitis (DPB) from clinical and pathological findings. Cryobiopsy is useful in diagnosing DPB as well as interstitial pneumonia and lung cancer.
一名70岁男性开始咳嗽。胸部X线显示中央有一个肿瘤，左侧胸腔积液，右侧有弥漫性颗粒状阴影。胸部计算机断层扫描（CT）显示支气管壁增厚和大量颗粒状阴影。我们怀疑是弥漫性泛细支气管炎。因此，进行了经支气管肺活检（TBLB）和经支气管肺冷冻活检（TBLC）。TBLB获得的组织大小为1毫米，TBLC在5秒时获得的组织大小为6毫米。TBLB标本的组织学分析显示淋巴细胞浸润，苏木精-伊红（HE）染色无纤维化，弹力纤维染色（EVG）无弹性纤维。另一方面，TBLC标本在HE染色中显示细支气管周围有炎性细胞浸润和纤维化，在EVG染色中显示弹性纤维肥大。根据临床和病理结果诊断为弥漫性泛细支气管炎（DPB）。冷冻活检在诊断DPB以及间质性肺炎和肺癌方面很有用。
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