Mori K, Yoshinouchi T, Ohtsuki Y
Shusou Public Hospital, Toyo City, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Jun;36(6):513-8.
A 68-year-old man with incomplete-type Behçet's disease was admitted to our hospital with a one-month history of a high fever and a persistent pulmonary infiltration shadow in the left lower lobe. Chest CT films showed localized round air-space consolidation in the left lower lobe. The fever did not responded to antibiotics, but did resolve with administration of prednisolone 15 mg/day. Left lower lobectomy was done to avoid life-threatening hemoptysis. Histological examination of the main pulmonary lesions revealed old vascular changes such as irregular intimal thickening and perivascular fibrosis. Disoriented elastic fibers of arteries was seen in some areas as were acute inflammatory foci with neutrophilic infiltration, and secondary organizing pneumonia with Masson bodies. From these findings Beçet's disease related pulmonary involvement could not be excluded. Localized secondary organizing pneumonia associated with acute inflammatory foci, as found in this case, is a very rare pulmonary manifestation of Behçet's disease.
一名68岁不完全型白塞病男性患者因高热1个月及左下肺持续性浸润影入住我院。胸部CT片显示左下叶局限性圆形气腔实变。发热对抗生素治疗无反应,但给予泼尼松龙15mg/天治疗后消退。为避免危及生命的咯血,行左下叶切除术。主要肺部病变的组织学检查显示有陈旧性血管改变,如不规则内膜增厚和血管周围纤维化。部分区域可见动脉弹性纤维排列紊乱,还有中性粒细胞浸润的急性炎症灶以及伴有马松小体的继发性机化性肺炎。根据这些发现,不能排除白塞病相关的肺部受累。本例中发现的与急性炎症灶相关的局限性继发性机化性肺炎是白塞病非常罕见的肺部表现。