Tamura A, Hebisawa A, Kurashima A, Kawabe Y, Machida K, Yotsumoto H, Mori M
Department of Respiratory Diseases, Tokyo National Chest Hospital, Kiyose.
Intern Med. 1997 Dec;36(12):865-9. doi: 10.2169/internalmedicine.36.865.
To assess the use of bronchofiberscopy for the diagnosis of allergic bronchopulmonary aspergillosis (ABPA), we retrospectively analyzed bronchofiberscopic and pathologic findings of specimens obtained by bronchofiberscopy in 8 patients who met the British criteria for ABPA. Two of the 8 patients completely met Rosenberg's primary criteria for ABPA, while the remaining 6 lacked only 1 or 2 immunologic and radiographic conditions of the criteria. Bronchofiberscopic inspection revealed the presence of mucus plugs in all patients. Pathologic examination of plug specimens obtained by suction from 6 of 7 of these patients showed that the plugs consisted of allergic mucin containing fungal hyphae, diagnostic of ABPA. Bronchofiberscopy appears to be a useful tool in the diagnosis of ABPA, if immunologic and radiographic findings are not typical of ABPA. This bronchofiberscopic method is easily applicable for diagnosing allergic bronchopulmonary fungal disease (ABPFD) in addition to ABPA.
为评估支气管纤维镜检查在变应性支气管肺曲霉病（ABPA）诊断中的应用，我们回顾性分析了8例符合英国ABPA诊断标准患者的支气管纤维镜检查及通过支气管纤维镜获取的标本的病理结果。8例患者中有2例完全符合罗森伯格ABPA主要标准，其余6例仅缺少标准中的1项或2项免疫学及影像学条件。支气管纤维镜检查显示所有患者均存在黏液栓。对其中7例患者中的6例通过吸引获取的栓子标本进行病理检查，结果显示栓子由含有真菌菌丝的变应性黏蛋白组成，可诊断为ABPA。如果免疫学及影像学表现不典型，支气管纤维镜检查似乎是ABPA诊断中的一种有用工具。这种支气管纤维镜检查方法除ABPA外，还易于应用于变应性支气管肺真菌病（ABPFD）的诊断。
