45例胆固醇性肺炎的临床病理及影像学观察  

Clinicopathological logical and imaging observation of 45 cases of cholesterol pneumonia

作　　者：康丽菲[1] 朱桂云[1] 邸红芹[2] 安晓颖[1] 李晓霞[1] 杨永辉[1] 

机构地区：[1]河北省胸科医院病理科,河北石家庄050041 [2]河北省胸科医院检验科,河北石家庄050041

出　　处：《河北医科大学学报》2017年第7期810-813,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(ZL20140205)

摘　　要：目的比较原发性和继发性胆固醇肺炎的临床病理及影像学特征,探讨胆固醇性肺炎的发病特点,为临床认识和诊疗该疾病提供理论依据。方法比较8例原发性胆固醇性肺炎和37例继发性胆固醇性肺炎的影像学表现,结合光镜下诊断、临床表现等总结病变特征。结果原发性和继发性胆固醇性肺炎临床表现为咳嗽咳痰偶有痰中带血、发热、胸闷气短等,2组差异无统计学意义(P>0.05)。原发性胆固醇性肺炎女性比例高于继发性胆固醇性肺炎,差异有统计学意义(P<0.05)。2组年龄>50岁比例和发病部位差异无统计学意义(P>0.05)。2组影像学表现构成比、环靶征、支气管充气充液征、伴胸膜增厚、伴纵膈淋巴结肿大差异均无统计学意义(P>0.05)。2组肿物最大径>3cm比例差异无统计学意义(P>0.05)。原发性和继发性胆固醇性肺炎光镜下均可见肺泡腔内出现泡沫细胞聚集、胆固醇裂隙多核巨细胞、间质淋巴细胞增生、肺泡上皮立方状增生。结论不同类型胆固醇性肺炎不能通过临床和影像学表现区分,其确诊仍需病理学诊断。胆固醇性肺炎影像学中结节肿块影、伴随表现环靶征和胸膜增厚均较多见以及光镜下泡沫细胞聚集等,可为临床诊疗提供理论依据。Objective To observe and compare the clinicopathologic feature between primary and secondary cholesterol pneumonia, and to discuss the clinical characters in order to providing theoretical basis for understanding and diagnosing diseases.Methods By comparing the imaging of 8 cases of primary cholesterol pneumonia and 37 cases of secondary, combined with the diagnosis under light microscope and the clinical feature , we sum up the characteristics using the statistical analysis.Results Clinical manifestation of primary and secondary cholesterol pneumonia mostly included sputum with blood in phlegm cough, fever, chest condition, etc.No significant difference was found in the two groups（P〉0.05）.The proportion of women with primary cholesterol pneumonia is higher than that of the secondary, and the difference was statistically significant（P〈0.05）.The ratio of age over 50 and the position of cholesterol pneumonia were not observed obvious difference in the two groups（P〉0.05）.The constituent ratio of the imaging, round target character, liquid air-filled bronchi, pleural thickening and mediastinal lymph node enlargement were not found significant difference in the two groups（P〉0.05）.There was no statistical significance of the ratio of the mass size which is more than 3cm in the two groups（P〉0.05）.The foam cells gathered in the alveolar space with cholesterol cleft and multinuclear giant cell under the light scope in primary and secondary cholesterol pneumonia, and the proliferation of lymphocytes was found in the pulmonary interstitium.Also, the cubic alveolar epithelial hyperplasia was observed.Conclusion Different types of cholesterol pneumonia cannot be distinguished by clinical and imaging manifestations, of which diagnosis was still subject to pathological diagnosis.The most common was nodular mass type, the accompanying manifestation including the round target character and pleural thickening and the foam cells aggregation in light microscope, which provided theoretical basis for clin

关 键 词：肺炎 脂质性 病理学 体层摄影术 螺旋计算机 

分 类 号：R563.19[医药卫生—呼吸系统]