隐源性、继发性及急性纤维素性机化性肺炎的临床、影像及预后比较  

Comparison of clinical manifestation,imaging and prognosis of cryptogenic,secondary and acute fibrinous organizing pneumonia

作　　者：吴月 朱晓萍[1] Wu Yue;Zhu Xiaoping(Department of Respiratory Diseases,Shanghai East Hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院呼吸医学中心,上海200120

出　　处：《国际呼吸杂志》2021年第9期696-702,共7页International Journal of Respiration

基　　金：国家自然基金面上项目(81970089)。

摘　　要：机化性肺炎是一种以肺泡、肺泡管或伴有细支气管内机化性肉芽组织为组织病理学特征的临床综合征。当它继发于结缔组织疾病、恶性肿瘤、药物、放疗、器官移植等时被称为继发性机化性肺炎。当无明确病因时为隐源性机化性肺炎,隐源性机化性肺炎是特发性间质性肺疾病中发病率居第三位的疾病。急性纤维素性机化性肺炎是特发性间质性肺炎的一种罕见病理学类型,其组织病理学表现为大面积分布的均质嗜酸性纤维素球,临床表现及胸部影像学无特异性,但预后相对较差,于2002年被Beasley等提出后,相关报道逐年增多。三者的临床表现、实验室检查以及影像学检查有很多相似之处,临床上容易混淆,而它们的治疗和预后却差别很大,所以现对隐源性机化性肺炎、继发性机化性肺炎和急性纤维素性机化性肺炎的临床特征、影像学特点及预后作一综述。Organizing pneumonia(OP)is a clinical syndrome characterized by the histopathological features of organized granulation tissue in alveoli,alveolar ducts or bronchioles.When certain factors are associated with OP,it is defined as secondary organizing pneumonia(SOP),these factors include connective tissue diseases,malignant tumors,drugs,radiotherapy,organ transplantation and so on.Cryptogenic organizing pneumonia(COP)is defined when no cause or underlying disease is found,it is the third most common disease among idiopathic interstitial lung diseases.Acute fibrinous and organizing pneumonia(AFOP)is a rare histologic pattern of idiopathic interstitial lung diseases,which is characterized histologically by homogeneous eosinophil fibrin balls within the alveoli.Clinical manifestations and imaging findings of AFOP are not specific,but its prognosis is worse.Since AFOP was found by Beasley in 2002,more and more cases have been reported.There are many similarities in the clinical manifestations,laboratory tests and imaging examinations of the above three diseases,which are easy to be confused clinically,but their treatment and prognosis are quite different.Therefore,the clinical features,imaging findings and prognosis of COP,SOP,and AFOP are reviewed as follows.

关 键 词：机化性肺炎 急性纤维素性机化性肺炎 影像学 预后 

分 类 号：R563.1[医药卫生—呼吸系统]