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Desquamative Interstitial Pneumonia Presenting with Consolidation and Hemoptysis

脫屑性間質性肺炎(desquamative interstitial pneumonia)-以肺實質化及咳血表現

摘要


脫屑性間質性肺炎是一種與吸菸高度相關的間質性肺病。常見的臨床表現是以運動性呼吸困難以及持續性乾咳為主。在胸部電腦斷層則主要呈現瀰漫性毛玻璃狀變化。我們提出討論的個案一開始以咳血表現,胸部電腦斷層顯示右中肺葉實質化加上瀰漫性毛玻璃狀的病變。藉由胸腔內視鏡輔助手術進行右中肺葉楔狀切除證實為脫屑性間質性肺炎,病人在接受類固醇治療以及戒菸之後咳血就改善了。咳血以及肺實質化都是脫屑性間質性肺炎罕見之表現,此個案提醒我們外科手術切片對於一些無法得到明確診斷的肺部間質疾病是非常有價值的。

並列摘要


Desquamative interstitial pneumonia (DIP) is a smoking-related interstitial lung disease. It usually develops in males, and presents with insidious exertional dyspnea and persistent nonproductive cough. Chest computed tomography usually shows diffuse ground-glass opacities in bilateral lungs. Here, we report a case of massive hemoptysis with right middle lobe (RML) consolidation and diffuse centrilobular ground glass opacities. The hemoptysis resolved after RML wedge resection, steroid therapy and smoking cessation. Hemoptysis and lung consolidation are rare presentations in patients with DIP. This case serves to remind us that tissue proof via surgical biopsy is of value in diagnosing interstitial lung disease, if less invasive examinations fail to obtain a definite diagnosis.

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