急性纤维素性机化性肺炎一例报告并文献复习  

Acute Fibrinous and Organizing Pneumonia: One Case Report and Literature Review

作　　者：秦湧[1] 崔进[1] 朱岩[2] 

机构地区：[1]南京医科大学第二附属医院呼吸科,江苏南京210011 [2]南京医科大学第一附属医院病理科,江苏南京210029

出　　处：《中国呼吸与危重监护杂志》2015年第6期577-582,共6页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的观察并总结急性纤维素性机化性肺炎(AFOP)的临床、影像学、实验室检查、病理学、治疗及预后的特点。方法回顾性分析南京医科大学第一附属医院2013年9月通过纤维支气管镜肺活检确诊的1例AFOP患者的临床资料、影像学及组织病理等特征。复习相关文献,总结AFOP的诊断及治疗进展。结果患者为50岁女性,亚急性起病,主要的临床表现为畏寒、发热、咳嗽、咳痰、胸痛。胸部CT平扫主要表现为右肺中叶、下叶见斑片状、结节状高密度影。主要组织病理表现为局灶性纤维素渗出,肺泡腔内大量泡沫细胞、淋巴细胞浸润;病理上不同于其他已经明确的急性肺损伤,如弥漫性肺泡损伤、隐源性机化性肺炎及急性嗜酸粒细胞性肺炎。经糖皮质激素治疗后患者的临床症状及影像学表现很快好转。结论 AFOP的临床、影像学及实验室检查等表现无特异性,诊断需依赖组织病理学。糖皮质激素治疗效果较好。Objective To explore the clinical,radiological and pathological characteristics of acute fibrinous and organizing pneumonia（ AFOP）. Methods A case pathologically diagnosed with AFOP in September 2013 in the Second Affiliated Hospital of Nanjing Medical University was reported,and the related literature was reviewed. Results A 50-year-old woman with fever,chills,cough with sputum and chest pain was admitted to this hospital. The chest CT showed the nodules and patching infiltrates of the right middle lung. The pathological examination revealed the focally exudation of fibrin,lymphocyte infiltration and the presence of foam cells within the alveolar spaces,which is different from other well-known acute lung injures such as diffuse alveolar damage, cryptogenic organizing pneumonitis, and acute eosinophilic pneumonia. Coticosteroid therapy was induced and the patient showed significantly clinical and radiological improvement. Conclusion AFOP has no specific clinical,laboratory tests and radiology features,and it＇s diagnosis depends on pathological examination. Treatment with coticosteroids is proved to be effective.

关 键 词：急性纤维素性机化性肺炎 间质性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]