Pai U, McMahon J, Tomashefski J F
Department of Pathology, Metrohealth Medical Center, Cleveland, OH 44109-1988.
Am J Clin Pathol. 1994 Jan;101(1):22-8. doi: 10.1093/ajcp/101.1.22.
The histopathology, ultrastructure, and clinicopathologic correlations in six patients with cardiac failure and iron encrustation of lung elastic tissue were examined at autopsy. Transmission electron microscopy (TEM) and energy dispersive x-ray analysis were applied to two cases. Of the group, five patients had cardiac failure due to systemic hypertension (4 patients), valvular disease (4 patients), or coronary atherosclerosis (4 patients). Biventricular failure in one patient was associated with sleep apnea. Both iron and calcium, identified by histochemical stains, impregnated degenerated alveolar and vascular elastic fibers and were associated with a foreign body reaction and focal interstitial fibrosis. Energy dispersive x-ray analysis and TEM demonstrated iron and calcium on the microfibrillar portion of elastin. Morphometry indicated vascular changes of pulmonary venous hypertension. The authors concluded that mineral deposition probably represents nonspecific precipitation of metallic ions on altered elastic fibers in patients with cardiac failure. "Mineralizing elastosis" potentially contributes to lung restriction and, occasionally, can be a source of diagnostic confusion.
对6例心力衰竭且肺弹性组织有铁沉着的患者进行了尸检，检查其组织病理学、超微结构及临床病理相关性。对其中2例应用了透射电子显微镜（TEM）和能量色散X射线分析。该组患者中，5例因系统性高血压（4例）、瓣膜病（4例）或冠状动脉粥样硬化（4例）导致心力衰竭。1例患者的双心室衰竭与睡眠呼吸暂停有关。组织化学染色鉴定出铁和钙，它们浸渍在退化的肺泡和血管弹性纤维中，并伴有异物反应和局灶性间质纤维化。能量色散X射线分析和TEM显示铁和钙存在于弹性蛋白的微纤维部分。形态测量表明存在肺静脉高压的血管变化。作者得出结论，矿物质沉积可能代表心力衰竭患者金属离子在改变的弹性纤维上的非特异性沉淀。“矿化弹性组织变性”可能导致肺限制性改变，偶尔还会造成诊断混淆。
