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嗜酸性粒细胞性肺病的影像学表现谱

The spectrum of eosinophilic lung disease: radiologic findings.

作者信息

Kim Y, Lee K S, Choi D C, Primack S L, Im J G

机构信息

Department of Radiology, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, South Korea.

出版信息

J Comput Assist Tomogr. 1997 Nov-Dec;21(6):920-30. doi: 10.1097/00004728-199711000-00015.

Abstract

PURPOSE

Eosinophilic lung disease includes various disease entities. Each disease manifests different radiologic findings. The purpose of this review is to present the radiologic findings of the spectrum of eosinophilic lung disease.

METHOD

We reviewed the radiologic, histologic, and clinical findings of the spectrum of eosinophilic lung disease from the previous reports and our experiences.

RESULTS

Simple pulmonary eosinophilia is characterized by transient and migrating opacities on chest radiography. Acute eosinophilic pneumonia is characterized by acute clinical symptoms and signs and rapid changes of radiographic diffuse reticular lesions. Chronic eosinophilic pneumonia, with more prolonged symptom duration, history of asthma, occurrence of relapse, and radiologic features of subpleural consolidation, can be differentiated from acute eosinophilic pneumonia. Allergic bronchopulmonary aspergillosis presents with bilateral central bronchiectasis with or without mucoid impaction. Although these diseases show specific radiographic findings, some show overlapping radiographic features. High-resolution CT enables characterization of parenchymal lesions further by showing internal and marginal features and the exact extent of the lesions. Extrapulmonary organs are involved in Churg-Strauss syndrome and idiopathic hypereosinophilic syndrome. Asthma is associated with Churg-Strauss syndrome, allergic bronchopulmonary aspergillosis, chronic eosinophilic pneumonia, and bronchocentric granulomatosis.

CONCLUSION

Integration of clinical, laboratory, and radiologic findings enables initial and differential diagnoses of various eosinophilic lung diseases.

摘要

目的

嗜酸性粒细胞性肺病包括多种疾病实体。每种疾病表现出不同的放射学表现。本综述的目的是介绍嗜酸性粒细胞性肺病谱系的放射学表现。

方法

我们回顾了既往报告及我们自身经验中嗜酸性粒细胞性肺病谱系的放射学、组织学和临床发现。

结果

单纯性肺嗜酸性粒细胞增多症的特征是胸部X线片上出现短暂性和游走性阴影。急性嗜酸性粒细胞性肺炎的特征是急性临床症状和体征以及放射学上弥漫性网状病变的快速变化。慢性嗜酸性粒细胞性肺炎症状持续时间更长,有哮喘病史、复发情况,且具有胸膜下实变的放射学特征,可与急性嗜酸性粒细胞性肺炎相鉴别。变应性支气管肺曲霉病表现为双侧中心性支气管扩张,伴或不伴黏液嵌塞。尽管这些疾病有特定的放射学表现,但有些表现出重叠的放射学特征。高分辨率CT通过显示实质病变的内部和边缘特征以及病变的确切范围,能够进一步对其进行特征性描述。肺外器官受累见于Churg-Strauss综合征和特发性高嗜酸性粒细胞综合征。哮喘与Churg-Strauss综合征、变应性支气管肺曲霉病、慢性嗜酸性粒细胞性肺炎和支气管中心性肉芽肿病相关。

结论

综合临床、实验室和放射学发现有助于对各种嗜酸性粒细胞性肺病进行初步诊断和鉴别诊断。

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