- 期刊
支氣管肺泡灌洗術在石綿症診斷的應用─病例報告
Application of Bronchoalveolar Lavage in the Diagnosis of Asbestosis: A Case Report
摘要
詳實的暴露史在間質性肺病變的診斷流程中，扮演相當重要的角色，職業史對職業性肺病診斷的確立更是一必要條件。然而，有時或因醫生的疏忽，或是病人對工作或周遭環境的認知不夠，因此無法得到正確或有意義的暴露史資料，此時一個客觀評量物質暴露的方法就有其重要性。本篇提出一56歲男性病例，藉由支氣管肺泡灌洗術（bronchoalveolar lavage，BAL）檢查中發現病人肺泡有大量石綿體，進而確定石綿症的診斷。在告知病人石綿症的預後以及抽菸對其罹患肺癌危險性有加成作用後，病人已戒菸，並規則在門診追蹤。BAL在間質性肺病診斷的重要性已無庸置疑，吾人若能熟悉石綿體在一般細胞學檢查的特殊發現，雖然沒有可靠暴露史的幫助，也能客觀而快速的確立病人的診斷
並列摘要
Thorough exposure history plays an important role in establishing a diagnosis of interstitial lung disease. Furthermore, occupational history is one of the criteria for the definite diagnosis of occupation lung disease. However, either the carelessness of the doctor or the ignorance to the working environment or living place of the patient, exposure history may be unavailable or unreliable sometimes. Therefore, an objective measurement of exposure is of clinical importance in this circumstance. We present a case of a 56 year-old man here. After identification of significant amount of asbestos bodies in the recovered bronchoalveolar lavage（BAL）fluid, we confirm the diagnosis of asbestosis. We have informed the patient about the outcome of asbestosis and the addictive effect of smoking on lung cancer. Then the patient has quit smoking and is regularly followed up at our OPD. The role of BAL in the diagnosis of interstitial lung disease is clinically considerable. If we are familiar with the characteristic finding of asbestos body in routine cytology smear of BAL fluid, we can make sure the asbestos exposure history rapidly and objectively even without the help of a reliable exposure history