Kubo M, Koshino T, Shimizu H, To Y, Toyota E, Kudo K, Kabe J, Niino H
Department of Pulmonology, International Medical Center of Japan, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Oct;35(10):1084-92.
A 76-year-old man was admitted to our hospital with a diffuse reticulo-nodular shadow on chest X-ray. He had no symptoms. Transbronchial lung biopsy specimens revealed alveolitis and small numbers of lymphocytes. Bronchoalveolar lavage fluid (BALF) analysis revealed an increased number of eosinophils. Few eosinophils were seen in the alveolar lumen on biopsy. The patient had no symptoms, and was discharged without therapy. He was followed as an outpatient. Dyspnea on effort gradually developed June 1995. The diffuse infiltrative shadows on chest CT worsened and the patient was again admitted. Laboratory data revealed an elevation of serum LDH. Tumor markers were negative. Desquamative interstitial pneumonia (DIP) was diagnosed on open lung biopsy. Corticosteroid therapy (1 mg/kg/day) was administered. After treatment with corticosteroid, chest CT findings and pulmonary function tests improved remarkably. DIP is less common in Japan than elsewhere. The characteristic findings of BALF taken from patients with DIP are still inperfectly characterized. Our patient exhibited an increased number of eosinophils. To the best of our knowledge, BALF findings were reported for six cases of DIP in Japan. In five out of the seven cases (including our case), BALF findings demonstrated an increased number of eosinophils. This finding may be one of the characteristic features in patients with DIP.
一名76岁男性因胸部X线显示弥漫性网状结节影入住我院。他没有症状。经支气管肺活检标本显示肺泡炎和少量淋巴细胞。支气管肺泡灌洗（BALF）分析显示嗜酸性粒细胞数量增加。活检时在肺泡腔内可见少量嗜酸性粒细胞。患者无症状，未经治疗出院。作为门诊患者进行随访。1995年6月逐渐出现劳力性呼吸困难。胸部CT上的弥漫性浸润影加重，患者再次入院。实验室检查显示血清乳酸脱氢酶升高。肿瘤标志物为阴性。经开胸肺活检诊断为脱屑性间质性肺炎（DIP）。给予皮质类固醇治疗（1mg/kg/天）。皮质类固醇治疗后，胸部CT表现和肺功能测试明显改善。DIP在日本比其他地方少见。DIP患者BALF的特征性表现仍未完全明确。我们的患者显示嗜酸性粒细胞数量增加。据我们所知，日本报道了6例DIP患者的BALF检查结果。在7例患者中的5例（包括我们的病例）中，BALF检查结果显示嗜酸性粒细胞数量增加。这一发现可能是DIP患者的特征之一。
