张中宏,牟向东,关键.支气管色素沉着纤维化的临床特征研究[J].内科急危重症杂志,2017,23(3):
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| 中文关键词: 支气管色素沉着纤维化 肺部高分辨CT、支气管镜镜检、病理改变 临床特征 |
| 英文关键词:Bronchial anthracofibrosis Pulmonary high resolution computerized tomography, bronchoscopy and pathologic change Clinical characteristics |
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| 中文摘要: |
| 【】 目的 研究支气管色素沉着纤维化的临床特征。方法 选取我院经电子支气管镜检查确诊的支气管色素沉着纤维化病例70例,回顾性分析、总结其肺部高分辨CT、支气管镜镜检、刷检细胞学及活检病理等改变 结果 支气管镜镜检：管腔改变情况：扭曲、变形20例,闭塞20例,裂隙样狭窄17例,环形狭窄3例；管腔黏膜改变情况：类肿瘤样增生3例,肥厚、水肿39例,肉芽肿样改变2例,丘状隆起8例,瘢痕样改变8例、坏死物5例,干酪样坏死物7例；管腔狭窄部位：主支气管：左主支气管2例,右主支气管1例；叶支气管：左肺上叶(8例),右肺中叶(22例)及上叶(14例)；段支气管：多见于左肺上叶尖后段及右肺上叶尖后段；其中多叶段管腔狭窄16例；HRCT：肺部影像学改变：肺间质改变15例,胸腔积液12例,胸膜增厚、粘连10例,肺结核25例,右肺中叶不张27例,右肺上叶不张5例,左肺上叶狭窄并肺不张18例,右肺下叶肺不张2例,左肺上叶上支狭窄1例,增殖、纤维化改变38例,肺部小结节影12例,陈旧性肺结核9例,斑片状阴影4例；淋巴结改变：纵膈淋巴结增大并钙化20例,肺门淋巴结增大并钙化10例,肺门淋巴结增大10例；病理改变情况：慢性黏膜炎20例,玻璃样变2例,尘细胞沉积1例,碳末沉积3例,纤维素渗出4例,间质纤维组织增生4例,干酪样坏死4例,局灶上皮鳞化3例,淀粉样变性1例； 结核感染相应指标：T-spot T.B试验阳性20例,PPD试验阳性16例。结论 BAF的肺部高分辨CT、支气管镜镜检、病理改变都具有一定特征性改变,与肺结核、慢性阻塞性肺疾病有相关性。 |
| 英文摘要: |
| [Abstract] Objective Research the clinical characteristics of bronchial anthracofibrosis. Methods Select 70 cases in our hospital who was definitely diagnosed with bronchial anthracofibrosis by bronchovideoscope, then retrospectively analyzed and concluded their changes in pulmonary high resolution computerized tomography, bronchoscopy, brush cytology and biopsy, etc. Results Bronchoscopy: changing situations in lumens: 20 cases with distortion and deformation, 20 cases with occlusion, 17 cases with slit like stenosis and 3 cases with annular stenosis; changing situations in mucosas: 3 cases with Type of tumor hyperplasia, 39 cases with hypertrophy and edema, 2 cases with granulomatous variations, 8 cases with hill like eminentia, 8 cases with ouloid variations, 5 cases with sphacelus and 7 cases with caseous materials; luminal stenosis: principle bronchi: 2 cases in left principal bronchus and 1cases in right principal bronchus; lobar bronchi: superior lobe of left lung (8 cases), middle lobe (22 cases) and superior lobe (14 cases) of right lung; segmental bronchi: seen majorly in posterior segments of the superior lobes of left lung and right lung, among which 16 cases were with multilobar segments stenosis. HRCT: imageological changes in lung: 15 cases with interstitial variations, 12 cases with pleural effusion, 10 cases with pleural thickness and adhesion, 25 cases with tuberculosis, 27 cases with atelectasis in middle lobe of right lung, 1 case with stenosis in superior branch of superior lobe of left lung, 38 cases with proliferation and fibrosis, 12 cases with pulmonary nodular shadows, 9 cases with obsolete pulmonary tuberculosis and 4 cases with patchy shadows; changes in lymph nodes: 20 cases with enlargement and calcification in mediastinal lymph nodes, 10 cases with enlargement and calcification in hilar lymph nodes and 10 cases with enlargement in hilar lymph nodes; pathologic changes: 20 cases with chronic mucositis, 2 cases with hyaline changes, 1 case with sedimentation of dust cells, 3 cases with anthracosis, 4 cases with fibrin exudation, 4 cases with hyperplasia of interstitial fibrous tissues, 4 cases with caseous necrosis, 3 cases with focal epithelial squamous metaplasia and 1 case with amyloidosis; relative indexes of tuberculosis: 20 cases with positive results of T-spot T.B test, 16 cases with positive results of PPD test. Conclusion There are some certain characteristic changes in pulmonary high resolution computerized tomography, bronchoscopy and pathologic changes of BAF, which relates to tuberculosis and chronic obstructive pulmonary diseases. |
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