Masuda S, Ishii T, Asuwa N, Ishikawa Y, Kiguchi H
Department of Pathology, Hachiouji Medical Center, Tokyo Medical College, Japan.
Pathol Res Pract. 1994 Nov;190(11):1095-100; discussion 1101-4. doi: 10.1016/S0344-0338(11)80910-6.
An autopsy case of granulomatous vasculitis confined to the pulmonary vasculature in a 40-year-old woman with widespread ovarian carcinoma is reported. Although gross lesions were not identified in the lungs other than a few metastatic tumor nodules, vascular lesions were demonstrated microscopically throughout both lungs. Histopathologically, granulomatous vasculitis was present only in the large and medium-calibered pulmonary arteries of elastic type and in pulmonary veins. Granulomas were distributed mainly in the media and adventitia. The lumina of arteries and veins were free from any occlusion or dilatation. In the granulomas, multinucleated giant cells of both foreign body and Langhans' types containing asteroid body often appeared with slight infiltration by T-lymphocytes. Fibrinoid necrosis was absent in the granulomatous lesions, and neutrophils and eosinophils were also not present. The pulmonary granulomatous vasculitis in this case is distinctly different from the other pulmonary necrotizing and granulomatous vasculitides previously reported.
报告了一例40岁患有广泛卵巢癌的女性局限于肺血管的肉芽肿性血管炎尸检病例。尽管除了少数转移瘤结节外，肺内未发现肉眼可见的病变，但显微镜下显示两肺均有血管病变。组织病理学上，肉芽肿性血管炎仅存在于弹性型大中口径肺动脉和肺静脉中。肉芽肿主要分布在中膜和外膜。动脉和静脉管腔无任何阻塞或扩张。在肉芽肿中，常出现含有星状体的异物型和朗汉斯型多核巨细胞，并伴有轻微的T淋巴细胞浸润。肉芽肿性病变中无纤维蛋白样坏死，也不存在中性粒细胞和嗜酸性粒细胞。该病例中的肺肉芽肿性血管炎与先前报道的其他肺坏死性和肉芽肿性血管炎明显不同。
