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肺骨化:综述

Pulmonary ossification: a review.

作者信息

Casal Ana, Ferreiro Lucía, Toubes María Elena, Valdés Luis

机构信息

Pulmonary Department, Álvaro Cunqueiro's Hospital, Integrated Management Organisation Structure Vigo, Pneumovigo I+I Research Group, Health Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.

Pulmonary Department, Santiago de Compostela University Hospital Complex, Santiago de Compostela, Spain.

出版信息

J Thorac Dis. 2025 May 30;17(5):3450-3455. doi: 10.21037/jtd-2024-2083. Epub 2025 May 26.

Abstract

Pulmonary ossification (PO) is a rare disease, especially in patients without a previous history of lung disease. PO has an indolent course that may progressively cause lung function impairment. It is characterized by the presence of ectopic metaplastic bone in the lungs. Although it is generally idiopathic, it may be associated with other diseases, such as interstitial lung diseases. High resolution computed tomography (HRCT) of the chest is the technology of choice for diagnosis, as it allows differential diagnosis with other diseases and spares the use of more aggressive diagnostic techniques. Distinctive radiological findings include two ossification patterns: dendriform and nodular (the most frequent). Each pattern is associated with specific histological findings and can be related to different entities or otherwise be idiopathic forms. This review provides an updated overview of the pathogenesis, diagnostic and histopathological criteria and prognostic factors. As specific treatment is not currently available, the objective is to prevent fibrotic interstitial progression. For a correct management of the disease, it is necessary to consider the associated comorbidities and closely monitor cases. The purpose of this approach is to prevent progression, in case it is associated with diffuse interstitial lung disease. Further research and long-term follow-up are necessary for a better understanding of the pathogenesis and prognosis of PO.

摘要

肺骨化(PO)是一种罕见疾病,尤其在既往无肺部疾病史的患者中。PO病程隐匿,可能会逐渐导致肺功能损害。其特征是肺部存在异位化生骨。虽然通常为特发性,但可能与其他疾病相关,如间质性肺疾病。胸部高分辨率计算机断层扫描(HRCT)是诊断的首选技术,因为它能与其他疾病进行鉴别诊断,避免使用更具侵入性的诊断技术。独特的影像学表现包括两种骨化模式:树枝状和结节状(最常见)。每种模式都与特定的组织学表现相关,可能与不同的疾病实体有关,否则可能是特发性形式。本综述提供了关于发病机制、诊断和组织病理学标准以及预后因素的最新概述。由于目前尚无特效治疗方法,目标是防止纤维化间质进展。为了正确管理该疾病,有必要考虑相关合并症并密切监测病例。这种方法的目的是在与弥漫性间质性肺疾病相关的情况下防止病情进展。为了更好地理解PO的发病机制和预后,还需要进一步研究和长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3de1/12170053/7afc8f8cbffc/jtd-17-05-3450-f1.jpg

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