Murayama T, Amitani R, Tsuyuguchi K, Watanabe I, Kimoto T, Suzuki K, Tanaka E, Kamei K, Nishimura K
Dept of Infection and Inflammation, Chest Disease Research Institute, Kyoto University, Japan.
Eur Respir J. 1998 Sep;12(3):745-7. doi: 10.1183/09031936.98.12030745.
A 69 yr old female was hospitalized for further examination of abnormal shadows on chest radiographs. She had a history of tuberculous pleurisy, rheumatoid arthritis and gold-induced interstitial pneumonia. On admission she still suffered from rheumatoid arthritis. A chest computed tomography scan on admission showed clusters of small nodules in subpleural regions of both lungs combined with bronchiectasis. Mycobacterium avium complex was cultured repeatedly from the sputum. Bronchoscopic examination disclosed white-yellow polypoid lesions in the orifice of the left B4 bronchus. Cultures of the brushing specimen of the polypoid lesions and bronchial aspirates from the B4 bronchus yielded smoky-grey mycelial colonies that were later identified as Scedosporium apiospermum. It was concluded that the polypoid bronchial lesions due to Scedosporium apiospermum were formed in the preexisting dilated bronchus caused by Mycobacterium avium complex pulmonary disease.
一名69岁女性因胸部X光片上的异常阴影入院进一步检查。她有结核性胸膜炎、类风湿性关节炎和金制剂所致间质性肺炎病史。入院时她仍患有类风湿性关节炎。入院时胸部计算机断层扫描显示双肺胸膜下区域有小结节簇，并伴有支气管扩张。多次从痰中培养出鸟分枝杆菌复合群。支气管镜检查发现左B4支气管开口处有黄白色息肉样病变。对息肉样病变的刷检标本和B4支气管的支气管吸出物进行培养，得到烟灰色菌丝菌落，后来鉴定为尖端赛多孢。结论是，由尖端赛多孢引起的息肉样支气管病变形成于鸟分枝杆菌复合群肺病所致的原有扩张支气管中。
