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肺结核继发机化性肺炎：一例报告

Organizing pneumonia secondary to pulmonary tuberculosis: A case report.

作者信息

Liu Min, Dong Xi-Yang, Ding Zhi-Xiang, Wang Qing-Hai, Li De-Hui

机构信息

Department of Infectious Diseases, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde 415000, Hunan Province, China.

出版信息

World J Clin Cases. 2024 Sep 16;12(26):5974-5982. doi: 10.12998/wjcc.v12.i26.5974.

DOI:10.12998/wjcc.v12.i26.5974
PMID:39286380
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11287503/
Abstract

BACKGROUND

Organizing pneumonia secondary to pulmonary tuberculosis is rare. Moreover, the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined. We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.

CASE SUMMARY

A 54 years old man, previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy, underwent nine months of antituberculosis treatment. Follow-up lung computed tomography revealed multiple new subpleural ground-glass opacities in both lungs, and a lung biopsy confirmed organizing pneumonia. Treatment continued with anti-tuberculosis agents and hormone therapy, and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption. No disease recurrence was observed after corticosteroid therapy discontinuation.

CONCLUSION

When treating patients with active pulmonary tuberculosis, if an increase in lesions is observed during anti-tuberculosis treatment, it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia, timely lung biopsy is essential for early intervention.

摘要

背景

继发于肺结核的机化性肺炎较为罕见。此外，肺结核与继发性机化性肺炎之间的时间界限尚未明确。我们报告一例在抗结核治疗九个月后发生的与肺结核相关的继发性机化性肺炎病例。

病例摘要

一名54岁男性，既往诊断为肺结核和结核性胸膜炎，接受了九个月的抗结核治疗。随访肺部计算机断层扫描显示双肺出现多个新的胸膜下磨玻璃影，肺活检证实为机化性肺炎。继续使用抗结核药物和激素治疗，随后的动态肺部计算机断层扫描检查显示病变吸收有所改善。停用皮质类固醇治疗后未观察到疾病复发。

结论

在治疗活动性肺结核患者时，如果在抗结核治疗期间观察到病变增多，有必要考虑结核相关继发性机化性肺炎的可能性，及时进行肺活检对于早期干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/12c40a18a66e/WJCC-12-5974-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/43e334ad7eb4/WJCC-12-5974-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/1d5fd3f4c00b/WJCC-12-5974-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/6be896c96d46/WJCC-12-5974-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/6577ba57dedc/WJCC-12-5974-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/4ea6b2c3daa7/WJCC-12-5974-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/486dad56458b/WJCC-12-5974-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/92fa335000d8/WJCC-12-5974-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/12c40a18a66e/WJCC-12-5974-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/43e334ad7eb4/WJCC-12-5974-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/1d5fd3f4c00b/WJCC-12-5974-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/6be896c96d46/WJCC-12-5974-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/6577ba57dedc/WJCC-12-5974-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/4ea6b2c3daa7/WJCC-12-5974-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/486dad56458b/WJCC-12-5974-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/92fa335000d8/WJCC-12-5974-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b99/11287503/12c40a18a66e/WJCC-12-5974-g008.jpg

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本文引用的文献

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BMC Infect Dis. 2023 Jun 1;23(1):372. doi: 10.1186/s12879-023-08334-5.
2
A review of organizing pneumonia.机化性肺炎综述
JAAPA. 2023 Mar 1;36(3):16-19. doi: 10.1097/01.JAA.0000918776.59717.eb.
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Organizing pneumonia.机化性肺炎
Radiologia (Engl Ed). 2022 Dec;64 Suppl 3:240-249. doi: 10.1016/j.rxeng.2022.08.002.
4
Algorithmic Approach to the Diagnosis of Organizing Pneumonia: A Correlation of Clinical, Radiologic, and Pathologic Features.机化性肺炎诊断的算法方法：临床、放射学和病理学特征的相关性
Chest. 2022 Jul;162(1):156-178. doi: 10.1016/j.chest.2021.12.659. Epub 2022 Jan 14.
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Cryptogenic organising pneumonia: current understanding of an enigmatic lung disease.特发性机化性肺炎：一种神秘肺部疾病的最新认识。
Eur Respir Rev. 2021 Aug 17;30(161). doi: 10.1183/16000617.0094-2021. Print 2021 Sep 30.
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[Cryptogenic organizing pneumonia versus secondary organizing pneumonia].[隐源性机化性肺炎与继发性机化性肺炎]
Pathologe. 2021 Feb;42(1):55-63. doi: 10.1007/s00292-020-00903-8. Epub 2021 Jan 18.
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BMC Pulm Med. 2020 Sep 22;20(1):252. doi: 10.1186/s12890-020-01292-7.
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Secondary organizing pneumonia following viral pneumonia caused by severe influenza B: a case report and literature reviews.重症乙型流感病毒所致病毒性肺炎后继发性机化性肺炎：1例报告及文献复习
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