Department of Laboratory Medicine and Pathology, Royal Alexandra and University of Alberta Hospitals, 10240 Kingsway NW, Edmonton, Alberta, Canada, T5H 3V9.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Division of Anatomic Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Surg Pathol Clin. 2024 Jun;17(2):173-192. doi: 10.1016/j.path.2023.11.004. Epub 2023 Dec 16.
Granulomas are frequently encountered by pathologists in all types of lung specimens and arise from diverse etiologies. They should always be reported as necrotizing or non-necrotizing, with microorganism stains performed to evaluate for infection. With attention to distribution, quality (poorly vs well-formed), associated features, and correlation with clinical, radiologic, and laboratory data, the differential diagnosis for granulomatous lung disease can usually be narrowed to a clinically helpful "short list." This review describes a practical approach to pulmonary granulomas and reviews the clinicopathological aspects of common entities, including infectious (mycobacteria, fungi) and noninfectious (hypersensitivity pneumonitis, sarcoid, and vasculitis) causes.
肉芽肿在各种类型的肺部标本中经常被病理学家遇到，其病因多种多样。它们应该始终被报告为坏死性或非坏死性，并进行微生物染色以评估感染。通过注意分布、质量（差与好）、相关特征以及与临床、放射学和实验室数据的相关性，肉芽肿性肺部疾病的鉴别诊断通常可以缩小到一个临床有用的“简短清单”。本文描述了一种实用的肺部肉芽肿方法，并回顾了常见实体的临床病理方面，包括感染性（分枝杆菌、真菌）和非感染性（过敏性肺炎、结节病和血管炎）原因。
