Ikeno Y, Asai S, Mashimoto H, Shimokawa I, Iwasaki K, Matsuo T, Ikeda T, Minami H
First Department of Pathology, Nagasaki University, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Feb;31(2):219-24.
A 68-year-old male presented with cough and sputum. He had suffered from these symptoms for ten years prior to admission. Chest roentgenogram revealed reticulonodular shadows in the lower fields of both lungs. CT scan of the chest revealed an interstitial pattern in the lower field of both lungs. Honeycombing and bullous pattern were also present in the subpleural area. The patient had a history of dust and asbestos inhalation while working as an electrician. Eosinophilia of the peripheral blood and BALF, and a slightly increased serum IgE concentration were noted. Open lung biopsy revealed interstitial fibrosis with intra-alveolar macrophage accumulation and asbestos bodies. The histopathological features resembled UIP and DIP, although DIP is uncommon in pulmonary asbestosis. The slightly increased serum IgE concentration was considered to be an additional effect of asbestos. This is a case of pulmonary asbestosis with intriguing immunological and histopathological features.
一名68岁男性因咳嗽和咳痰就诊。入院前他出现这些症状已有十年。胸部X线片显示双肺下野有网状结节阴影。胸部CT扫描显示双肺下野呈间质样改变。胸膜下区域也出现蜂窝状和大疱样改变。该患者曾在担任电工期间有粉尘和石棉吸入史。外周血和支气管肺泡灌洗液嗜酸性粒细胞增多,血清IgE浓度略有升高。开胸肺活检显示间质纤维化伴肺泡内巨噬细胞积聚和石棉小体。组织病理学特征类似于特发性间质性肺炎(UIP)和脱屑性间质性肺炎(DIP),尽管DIP在肺石棉沉着病中并不常见。血清IgE浓度略有升高被认为是石棉的额外影响。这是一例具有有趣免疫和组织病理学特征的肺石棉沉着病病例。