静悄悄的肺部阴影  

Silent pulmonary shadows

作　　者：孙忻 李玉红[2] 高莉[3] 胡晓文 张婷[1] 许文兵[1] 彭敏[1] 施举红[1] 冯瑞娥[5] Sun Xin;Li Yuhong;Gao Li;Hu Xiaowen;Zhang Ting;Xu Wenbing;Peng Min;Shi Juhong;Feng Rui′e(Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Pulmonary and Critical Care Medicine,Qinghai University Affliated Hospital,Xining 810012,China;Department of Radiology,Peking Union First Hospital,Beijing 100034,China;Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of USTC,Hefei 230001,China;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京100730 [2]青海大学附属医院呼吸与危重症医学科,西宁810012 [3]北京大学第一医院医学影像科,北京100034 [4]中国科学技术大学附属第一医院呼吸与危重症医学科,合肥230001 [5]中国医学科学院北京协和医学院北京协和医院病理科,北京100730

出　　处：《中华结核和呼吸杂志》2024年第5期444-449,共6页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：本文报道1例老年女性患者,主因“体检发现肺部阴影1年,咳嗽咳痰2个月”就诊。患者胸部CT提示双肺实变及磨玻璃影,纵隔窗可见实变内部低密度影,既往因鼻咽癌放疗及长期薄荷油滴鼻病史为诊断提供重要线索,通过肺穿刺活检病理及支气管镜肺泡灌洗证实为外源性脂质性肺炎,停用滴鼻油后症状好转。本患者的诊治过程提醒临床医生应重视对误吸危险因素的识别和管理,提高对误吸相关肺部综合征的认识。An elderly woman with a 1-year history of pulmonary shadows was admitted because of intermittent cough and sputum production for 2 months.Chest computed tomography(CT)scans showed bilateral consolidations and ground-glass opacities,with areas of low attenuation inside consolidative opacities on the mediastinal window.Previous history of radiotherapy for nasopharyngeal carcinoma and long-term use of a compound menthol nasal drops provided were important clues to the diagnosis.CT scan-guided needle lung biopsy and bronchoalveolar lavage were performed,and lipid-laden macrophages were confirmed in both bronchoalveolar lavage and lung tissue.Final diagnosis of exogenous lipoid pneumonia was made on the basis of her risk factors for aspiration,history of oil exposure,and classic radiological and histopathological features.Symptoms improved after discontinuation of causative exposure.It is important for clinicians to raise awareness of exogenous lipoid pneumonia and other aspiration lung diseases.

关 键 词：肺炎 脂质性 活组织检查 肺 支气管肺泡灌洗液 肺炎 吸入性 

分 类 号：R563[医药卫生—呼吸系统]