Patchefsky A S, Israel H L, Hoch W S, Gordon G
Thorax. 1973 Nov;28(6):680-93. doi: 10.1136/thx.28.6.680.
, , 680-693. The clinical course and radiographic and pathological findings in 14 patients having the histological pattern of desquamative interstitial pneumonia (DIP) have been studied. Four deaths occurred from cardiorespiratory failure and two from other diseases, and one patient has severe pulmonary insufficiency. Seven patients had altered immunological reactivity or arthritis. Necropsy of three patients, one who died of respiratory insufficiency and two of other diseases, revealed diffuse pulmonary fibrosis with loss of the desquamative features noted on biopsy. One patient had had industrial exposure to tungsten carbide dust and -ray diffraction analysis of the post-mortem lung showed high concentrations of this substance. Ultrastructural observation and direct immunofluorescent staining of one specimen demonstrated fibrin in the alveolar space, a feature usually regarded as distinguishing DIP from chronic fibrosing interstitial pneumonia. Our clinical and pathological observations suggest that the histological pattern recognized as DIP may be a non-specific reaction to diverse forms of injury, which is not clearly separable from the usual type of diffuse interstitial fibrosis.
对14例具有脱屑性间质性肺炎（DIP）组织学模式患者的临床病程、影像学及病理学表现进行了研究。4例死于心肺功能衰竭，2例死于其他疾病，1例有严重肺功能不全。7例患者有免疫反应改变或关节炎。对3例患者进行尸检，其中1例死于呼吸功能不全，2例死于其他疾病，尸检显示弥漫性肺纤维化，活检时所见的脱屑性特征消失。1例患者曾有工业接触碳化钨粉尘史，死后肺组织的X射线衍射分析显示该物质浓度很高。对1份标本的超微结构观察和直接免疫荧光染色显示肺泡腔内有纤维蛋白，这一特征通常被认为是DIP与慢性纤维化性间质性肺炎的区别所在。我们的临床和病理学观察表明，被认为是DIP的组织学模式可能是对多种形式损伤的非特异性反应，与通常类型的弥漫性间质性纤维化并无明显区别。
