Kradin R L, Spirn P W, Mark E J
Chest. 1985 May;87(5):662-7. doi: 10.1378/chest.87.5.662.
The clinical, radiographic, and pathologic material from ten patients with intrapulmonary lymph nodes was analyzed, along with information from all previously reported cases. In our series the median age was 56 years, and 80 percent (eight) of the patients were men. All patients are or were cigarette smokers. Sixty percent (six) had a history of exposure to either asbestos, nonfibrous silicates, or both. There were no characteristic symptoms attributable to the intrapulmonary lymph nodes. Forty percent (four) had an unexplained pulmonary nodule or nodules on the chest roentgenogram, which prompted further diagnostic studies, including thoracotomy, to rule out a malignant neoplasm. Radiographically, in our cases and in the literature, almost all cases of intrapulmonary lymph nodes are subpleural, inferior to the level of the carina, and less than 2.0 cm in diameter. Thirty-five percent are multiple. Pathologically, in our cases, all intrapulmonary lymph nodes were markedly anthracotic, and 60 percent were additionally silicotic. Although their histogenesis is uncertain, intrapulmonary lymph nodes are probably hyperplastic lymphoid nodules related to inhalation of irritant dusts and attendant distortion of local lymphatic vessels. Precise clinical and radiographic analysis correlated carefully with cytologic and histologic material obtained by percutaneous needle biopsy should obviate exploratory thoracotomy in most instances.
对10例肺内淋巴结患者的临床、影像学和病理资料进行了分析，并结合了所有既往报道病例的信息。在我们的系列病例中，中位年龄为56岁，80%（8例）患者为男性。所有患者现在或曾经吸烟。60%（6例）有接触石棉、非纤维性硅酸盐或两者的病史。没有可归因于肺内淋巴结的特征性症状。40%（4例）在胸部X线片上有一个或多个不明原因的肺结节，这促使进行进一步的诊断研究，包括开胸手术，以排除恶性肿瘤。在影像学上，在我们的病例以及文献中，几乎所有肺内淋巴结病例都位于胸膜下，在隆突水平以下，直径小于2.0 cm。35%为多发。在病理上，在我们的病例中，所有肺内淋巴结均有明显的炭末沉着，60%还伴有矽肺。尽管其组织发生尚不确定，但肺内淋巴结可能是与吸入刺激性粉尘及伴随的局部淋巴管扭曲有关的增生性淋巴小结。在大多数情况下，精确的临床和影像学分析与经皮针吸活检获得的细胞学和组织学资料仔细关联，应可避免开胸探查。
