Myou S, Nishi K, Ooka T, Nomura M, Fujimura M, Matsuda T
Division of Respiratory Medicine, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Jun;32(6):571-7.
A 63-year-old male with a history of cement exposure visited our hospital in August of 1992 with chief complaints of yellow sputum and cough. Chest CT on admission revealed segmental fine nodular shadows in the right lower lobe and a band-like shadow in the left lower lobe. The transbronchial lung biopsy (TBLB) specimen showed alveolitis with a minimal degree of eosinophilic infiltration and organizing exudates in the dilated peripheral air spaces. The open lung biopsy specimens showed, in addition to the TBLB observations, lymphoid hyperplasia, dust deposition, and cystic dilatation of alveolar ducts. After treatment with corticosteroids, but not antibiotics, the abnormal opacities disappeared. This case appears to be characteristic of both bronchiolitis obliterans organizing pneumonia and a chronic eosinophilic pneumonia pattern.
一名有接触水泥史的63岁男性于1992年8月因主诉黄痰和咳嗽就诊于我院。入院时胸部CT显示右下叶有节段性细小结节影,左下叶有条带状影。经支气管肺活检(TBLB)标本显示肺泡炎,伴有轻度嗜酸性粒细胞浸润,扩张的外周气腔内有组织渗出物。开胸肺活检标本除了有TBLB所见外,还显示淋巴样增生、粉尘沉积和肺泡管囊性扩张。使用皮质类固醇而非抗生素治疗后,异常阴影消失。该病例似乎具有闭塞性细支气管炎机化性肺炎和慢性嗜酸性肺炎模式的特征。