Wöckel W, Heller K, Volkmer I
Dtsch Med Wochenschr. 1986 Feb 14;111(7):264-7. doi: 10.1055/s-2008-1068438.
A left upper lobectomy was performed on a 27-day-old male infant with clinically suspected congenital lobar emphysema. At operation a cranial pericardial hiatus was also noted. The infant died ten days postoperatively of a septicaemia of extrapulmonary origin. An autopsy was not performed. Histologic examination of the left upper lobe revealed the changes to be pulmonary lymphangiectasis, which is only rarely unilateral or unilobar. In this infant alveolar rupture is thought to have provided air entry into the primarily ectatic lymphatic vessels with further spread of air. The clinical symptoms were due to this complication. This interpretation is supported by the finding of numerous foreign-body giant cells in the lymph vessels, an extraordinary finding in congenital pulmonary lymphangiectasis.
对一名临床怀疑患有先天性大叶性肺气肿的27日龄男婴实施了左上肺叶切除术。手术中还发现有一个颅侧心包裂孔。该婴儿术后十天死于肺外源性败血症。未进行尸检。左上肺叶的组织学检查显示病变为肺淋巴管扩张症,这种情况很少为单侧或单叶性。据认为,在该婴儿中,肺泡破裂使空气进入原本就扩张的淋巴管,并导致空气进一步扩散。临床症状归因于这一并发症。淋巴管内发现大量异物巨细胞支持了这一解释,这在先天性肺淋巴管扩张症中是一个不同寻常的发现。