Yamawaki I, Kawatani K, Uno H, Tamaoki J, Kaburagi T, Ohnuki T, Nagai A
First Department of Medicine, Tokyo Women's Medical College, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Jan;36(1):90-4.
A case of pulmonary eosinophilic granuloma that underwent spontaneous remission is presented. A 23-year old man presented with dry cough and fever. Chest X-ray film revealed diffuse reticulo-nodular infiltrates in the middle and upper lung fields. Chest CT and HRCT showed multiple cystic lesions with thick walls and small nodules predominantly in the inner zone. Based on radiographic findings, pulmonary eosinophilic granuloma was suspected. Bronchoalveolar lavage cell data showed lymphocyte and eosinophil alveolitis with no increase of CD 1 lymphocytes. The symptoms and radiographic findings improved markedly within 4 months after the onset of symptoms without treatment and upon cessation of smoking. Chest CT and HRCT showed that the cystic walls were thinner and that the small nodules had decreased. Thoracoscopic lung biopsy revealed granulomatous lesions consisting of CD 1 and S-100 protein positive histiocytes with infiltration of eosinophils and fibrous lesions. Pulmonary eosinophilic granuloma was diagnosed. There has been no recurrence for 1 year.
本文报告一例自发性缓解的肺嗜酸性肉芽肿病例。一名23岁男性,表现为干咳和发热。胸部X线片显示中上肺野弥漫性网状结节状浸润。胸部CT和高分辨率CT显示多个壁厚的囊性病变及主要位于内带的小结节。基于影像学表现,怀疑为肺嗜酸性肉芽肿。支气管肺泡灌洗细胞数据显示淋巴细胞和嗜酸性粒细胞肺泡炎,CD1淋巴细胞无增加。在未治疗且戒烟后,症状和影像学表现于症状出现后4个月内明显改善。胸部CT和高分辨率CT显示囊性壁变薄,小结节减少。胸腔镜肺活检显示由CD1和S-100蛋白阳性组织细胞组成的肉芽肿性病变,伴有嗜酸性粒细胞浸润和纤维性病变。诊断为肺嗜酸性肉芽肿。1年来无复发。