脱屑性间质性肺炎伴支气管肺泡灌洗液嗜酸性粒细胞增多1例。

Nihon Kyobu Shikkan Gakkai zasshi Pub Date : 1997-10-01
M Kubo, T Koshino, H Shimizu, Y To, E Toyota, K Kudo, J Kabe, H Niino
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引用次数: 0

摘要

一位76岁男性患者在胸部x线片上表现为弥漫性网状结节影。他没有任何症状经支气管肺活检显示肺泡炎和少量淋巴细胞。支气管肺泡灌洗液(BALF)分析显示嗜酸性粒细胞数量增加。肺泡腔活检可见少量嗜酸性粒细胞。患者无症状,未经治疗出院。他作为门诊病人被跟踪。1995年6月,呼吸困难逐渐加重。胸部CT上弥漫性浸润影加重,再次入院。实验室数据显示血清乳酸脱氢酶升高。肿瘤标志物均为阴性。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)。经皮质类固醇治疗后,胸部CT表现及肺功能均有明显改善。DIP在日本不像在其他地方那么普遍。DIP患者BALF的特征性表现仍不完全明确。我们的病人表现出嗜酸性粒细胞增多。据我们所知,在日本报道了6例DIP的BALF结果。在7例中有5例(包括我们的病例),BALF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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A case of desquamative interstitial pneumonia with increased numbers of eosinophils in the bronchoalveolar lavage fluid].

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.

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