双肺多发结节伴血嗜酸性粒细胞增多1例  

A case of hypereosinophilia with diffuse pulmonary nodules

作　　者：陈茹萱 朱文艳 李玉红[2] 高莉[3] 张伟宏[4] 常龙[5] 彭敏[1] 田欣伦 施举红[1] 冯瑞娥[6] Chen Ruxuan;Zhu Wenyan;Li Yuhong;Gao Li;Zhang Weihong;Chang Long;Peng Min;Tian Xinlun;Shi Juhong;Feng Rui′e(Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pulmonary and Critical Care Medicine,Qinghai University Affiliated Hospital,Xining 810000,China;Department of Radiology,Peking University First Hospital,Beijing 100034,China;Department of Radiology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Hematology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pathology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科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810000 [3]北京大学第一医院医学影像科,北京100034 [4]中国医学科学院北京协和医院放射科,北京100730 [5]中国医学科学院北京协和医院血液内科,北京100730 [6]中国医学科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6期542-546,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：本文报道1例36岁女性患者,主要表现为咳嗽、气短、外周血嗜酸性粒细胞显著升高,胸部CT显示双肺多发结节、纵隔淋巴结肿大。先后两次支气管镜检查,镜下表现正常,肺泡灌洗液嗜酸性粒细胞比例升高,经支气管镜肺活检及纵隔淋巴结针吸活检提示肺组织及淋巴结内嗜酸性粒细胞浸润。因足量糖皮质激素治疗效果欠佳,行外科肺活检明确诊断为血管免疫母细胞性T细胞淋巴瘤。患者接受化疗后病情部分缓解,外周嗜酸性粒细胞降至正常,肺内结节明显减少。We reported a case of a 36-year-old woman who presented with cough,dyspnea,hypereosinophilia,multiple pulmonary nodules and mediastinal lymphadenopathy.The percentage of eosinophils in bronchoalveolar lavage fluid(BALF)was as high as 65%.Pathogenic tests and cytologic examination of BALF were negative.Transbronchial lung biopsy and endobronchial ultrasound-guided transbronchial needle aspiration revealed only eosinophil infiltration.As the patient responded poorly to high-dose corticosteroids,a surgical lung biopsy was performed.The pathological diagnosis was angioimmunoblastic T-cell lymphoma.The patient received chemotherapy and achieved a partial response.Her eosinophil count returned to the normal range,and the pulmonary nodules on chest CT partially resolved.

关 键 词：结节 肺 淋巴瘤 肺嗜酸粒细胞增多 

分 类 号：R563[医药卫生—呼吸系统]