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一名新冠病毒疾病(COVID-19)幸存者在发病六个月后经支气管肺冷冻活检诊断为活动性肺间质纤维化。

Active pulmonary interstitial fibrosis in a COVID-19 survivor diagnosed by transbronchial lung cryobiopsy six months after onset.

作者信息

Muto Yutaka, Okudela Koji, Nakazawa Atsuhito, Hisakane Kakeru, Matsumura Mai, Takemura Tamiko, Iwasawa Tae, Ogura Takashi

机构信息

Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama 236-0051, Japan.

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8953, Japan.

出版信息

Hum Pathol Rep. 2022 Sep;29:300666. doi: 10.1016/j.hpr.2022.300666. Epub 2022 Jun 27.

Abstract

We present a 76-year-old man who visited our center because of persistent dyspnea with hypoxia on exertion 6 months after onset of coronavirus disease 2019. Chest computed tomography showed bilateral extensive subpleural reticulation with traction bronchiectasis predominantly in the lower lung lobes. Transbronchial lung cryobiopsy revealed spatially and temporally intermittent interstitial fibrosis with mild lymphoid cell infiltration. Not only were there membranous fibrotic scars on the alveolar septa, but there were scattered foci of alveolar collapse with young fibroblastic proliferations, suggesting progressive interstitial fibrotic lesions. In addition to fibrotic phase of diffuse alveolar damage, the acceleration of subclinical preexisting interstitial lung abnormalities might have affected his respiratory condition.

摘要

我们报告一名76岁男性,他在2019冠状病毒病发病6个月后因劳力性呼吸困难伴低氧血症前来我院就诊。胸部计算机断层扫描显示双侧广泛的胸膜下网状改变伴牵拉性支气管扩张,主要累及下肺叶。经支气管肺冷冻活检显示存在时空上间歇性的间质纤维化,并伴有轻度淋巴细胞浸润。肺泡间隔不仅有膜性纤维化瘢痕,还存在散在的肺泡萎陷灶伴幼稚成纤维细胞增生,提示存在进行性间质纤维化病变。除了弥漫性肺泡损伤的纤维化期外,亚临床存在的间质性肺异常加速进展可能影响了他的呼吸状况。

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Post-acute COVID-19 syndrome.新冠病毒感染后长期综合征。
Nat Med. 2021 Apr;27(4):601-615. doi: 10.1038/s41591-021-01283-z. Epub 2021 Mar 22.

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