摘要
一位七十九歲男性之阻塞性細支氣管炎機化性肺炎於此報告。這位病人三個月前因類似感冒後，即出現輕度呼吸困難、食慾變差、及體重減輕四公斤。胸部放射學檢查出現兩側肺部斑塊狀浸潤及部份實質樣變化和毛玻璃樣混濁化。肺功能檢查表現輕度局限性非阻塞性變化。病人接受手術肺臟切片，病理檢查顯示間質性肺炎，組織學上並在肺胞及肺胞管內出現分枝狀黏液水腫樣結締組織，及在細枝氣管腔內出現息肉狀黏液水腫樣結締組織，病理診斷為阻塞性細支氣管炎機化性肺炎。病人接受類固醇治療，反應非常良好，一星期內症狀即改善且胸部X光片幾乎完全恢復正常。免疫組織病理檢查顯示增生的結締組織有毛細血管及CD34和第八因子陽性之內皮細胞增生，並且有S100蛋白陽性之樹枝狀大細胞存在，及肌動蛋白陽性之肌纖維組織母細胞，其結果與文獻上報告阻塞性細枝氣管炎機化性肺炎所增生之結締組織與普通型間質性肺炎並不相同是一致的。
並列摘要
A 79 year-old male with bronchiolitis obliterans organizing pneumonia (BOOP) is reported herein. The patient presented mild dyspnea and poor appetite with a 4 kg body weight loss for 3 months following a flu-like illness. The chest radiology unveiled bilateral patchy infiltrates with areas of consolidation and ground glass opacities. The pulmonary function test revealed mild restriction and no obstruction. The pathology of open lung biopsy showed interstitial pneumonia with loose myxoedematous tissue in branching plugs within the alveolar ducts and alveoli as well as in intraluminal polypoid nodules within the bronchioles. The patient responded dramatically to the steroid therapy with a nearly complete resolution within a week. Immunohistochemical studies showed rich capillarization with numerous CD34-positive and factor Ⅷ-positive endothelial cells as well as the presence of large S100-posive dendritic cells in the proliferative connective tissue with actin-positive myofibroblasts, comparable with the reported results of the different proliferative connective tissue in BOOP and usual interstitial pneumonia.
延伸閱讀
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