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["发胶肺”。临床及形态学表现]

["Hair-spray lung". Clinical and morphological findings].

作者信息

Gebbers J O, Burkhardt A, Tetzner C, Rüdiger H W, von Wichert P

出版信息

Schweiz Med Wochenschr. 1980 Apr 19;110(16):610-5.

PMID:6994218
Abstract

We present two cases of an uncommon lung disease. The considerable decrease in respiratory function was in sharp contrast with the moderate changes seen in the lung. Whereas the radiographs only revealed a milky and a slightly reticular cloudiness of the lungs, pulmonary vital capacity and compliance were reduced to one half of the standard value. Open lung biopsies were performed. Histological examination showed a fibrosing alveolitis with considerable response and foreign body reaction of the alveolar and interstitial macrophages. Intraalveolar and interstitial granulomas included macrophages and multinucleated giant cells of the foreign body type. They frequently enclosed PAS-positive material. Ultrastructural examination revealed distinct lysosomal inclusions in the macrophages and giant cells. Similar inclusions were induced in guinea pigs by hair-spray components. These findings led to the diagnosis of an exogenous thesaurosis of the lung. Prolonged and excessive exposure to hair-sprays could be established in both cases. Upon termination of the exposure, a marked improvement occurred in both patients within half a year. Extreme exposure to hair-spray may cause alterations of the lung parenchyma, including a so-called "hair-spray lung". The present report is directed towards a better understanding of this particular disease which is one of the numberous conditions induced by the increasing air pollution.

摘要

我们报告两例罕见的肺部疾病。呼吸功能的显著下降与肺部所见的中度变化形成鲜明对比。X线片仅显示肺部有乳状和轻微网状模糊影,而肺肺活量和顺应性却降至标准值的一半。我们进行了开放性肺活检。组织学检查显示为纤维化肺泡炎,伴有肺泡和间质巨噬细胞的显著反应及异物反应。肺泡内和间质肉芽肿包含巨噬细胞和异物型多核巨细胞,它们常包绕PAS阳性物质。超微结构检查显示巨噬细胞和巨细胞中有明显的溶酶体包涵体。发胶成分可在豚鼠中诱导出类似的包涵体。这些发现导致了肺外源性贮积症的诊断。在这两例病例中均证实存在长期和过度接触发胶的情况。停止接触后,两名患者在半年内均有明显改善。极度接触发胶可能导致肺实质改变,包括所谓的“发胶肺”。本报告旨在更好地理解这种特殊疾病,它是空气污染增加所引发的众多病症之一。

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