[Show abstract][Hide abstract] ABSTRACT: To highlight the etiological diagnosis of pulmonary granulomatosis.
The clinical, radiological and pathological data of a patient with sarcoidlike lung granulomatosis confirmed by open lung biopsy were presented, and relevant literatures were reviewed.
A 50-year-old female worker presented with intermittent cough and dyspnea for 3 years, after exposure to aluminum dust for 15 years. Radiographs of the chest and high-resolution CT demonstrated bilateral areas of ground-glass attenuation, patchy areas of consolidation, extensive reticular hyper-attenuating areas and traction bronchiectasis. Lung function studies showed a restrictive pattern with a low diffusion capacity. Lung biopsy specimens confirmed the presence of diffuse, noncaseating granulomatous nodules. Scanning electron microscopy and energy-dispersive radiograph analysis revealed large quantities of foreign particles mainly containing aluminum in granulomas. Her cough, dyspnea, radiological shadowing and pulmonary function showed marked improvement after corticosteroid therapy.
With the occupational history, histological and mineralogical studies, the patient was considered to have pulmonary sarcoidlike granulomatosis, most likely related to occupational exposure to aluminum dust. The search for any possible relevant exposure of a patient with suspected sarcoidosis seems mandatory.
No preview · Article · Jul 2008 · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
[Show abstract][Hide abstract] ABSTRACT: To describe the clinical and pathological features of primary NK/T cell lymphoma of the lung.
Two cases of primary NK/T cell lymphoma of the lung were reported, and the clinical, radiological and pathological characteristics of the disease were discussed with literature review of 3 cases.
Most patients presented with fever, cough and dyspnea, and antibiotics were ineffective. Radiographic findings included solitary or multiple nodules and consolidation, unilateral orbilateral pleural effusions (4/5), without hilar or mediastinal adenopathy. Ebstein-Barr virus was positive in cases patients (3/5). Histopathology revealed a great deal of abnormal lymphocyte infiltration, which were angio-centric with marked tissue putrescence and angio-destruction. Immunophenotyping showed CD56(+), CD3(+), perform (+), T-cell intracytoplasmic antigen-1(+) and/or GranB(+), but CD20(-). Most patients died of respiratory failure in half a year (4/5).
Primary NK/T cell lymphoma of the lung is rare, but should be considered when patients present with lung shadows and fever non-responsive to antibiotics, decreased WBC and increased LDH.
No preview · Article · Mar 2008 · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
[Show abstract][Hide abstract] ABSTRACT: To describe the characteristics of high-resolution CT(HRCT) findings of nonspecific interstitial pneumonia (NSIP) and the correlation with pathological changes.
The HRCT features of 9 cases (3 men and 6 women) of histopathologically confirmed NSIP were retrospectively analyzed and correlated with the pathological findings.
The predominant HRCT features, found in all the cases, were bilaterally patchy areas of ground-glass opacity with or without areas of consolidation. Irregular linear opacities, traction bronchiectasis, and thickening of bronchovascular bundles were also frequently seen. The abnormalities were distributed over the peripheral zones of the middle and lower lungs in most cases. Honeycombing was not a feature in all the cases. Areas of ground-glass opacity with or without irregular linear opacity or traction bronchiectasis corresponded pathologically to areas of interstitial thickening caused by varying degrees of interstitial inflammation and fibrosis showing temporal uniformity. Areas of consolidation were associated with extensive collagen-type interstitial fibrosis and mild interstitial inflammation at the biopsy sites, and occasionally represented the areas of bronchiolitis obliterans organizing pneumonia, foamy cell collections in alveolar spaces, or microscopic honeycombing with mucin stasis.
The HRCT manifestations of NSIP are characteristic though not specific. In patients with consistent clinical features, the diagnosis of NSIP can be suspected by typical HRCT findings.
No preview · Article · Feb 2008 · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
[Show abstract][Hide abstract] ABSTRACT: To highlight the characteristics of giant cell interstitial pneumonia (GIP).
The clinical, radiological and pathological data of a patient with GIP confirmed by open lung biopsy were presented, and relevant literatures were reviewed.
Patients with GIP usually had a history of exposure to metal dust. Clinical presentations include cough and dyspnea on exertion, and pulmonary function testing showed a restrictive abnormality. On chest radiography and high-resolution CT scans, it presents as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The main pathological findings include a desquamative interstitial pneumonia (DIP)-like reaction with intra-alveolar macrophages and numerous large multinucleated histiocytes that ingested inflammatory cells were admixed with macrophages. The finding of GIP is almost pathognomonic for hard metal pneumoconiosis.
GIP is a very rare chronic interstitial pneumonia, and has no characteristic clinical manifestations. Radiographic findings are similar to other idiopathic interstitial pneumonias. Meticulous history taking on occupational exposure is important for the diagnosis of GIP.
No preview · Article · Jun 2006 · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
[Show abstract][Hide abstract] ABSTRACT: In summary, GIP has no characteristic clinical manifestations, and radiographic findings of abnormalities are similar to those of other idiopathic interstitial pneumonias including idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Physicians should carefully assess the causative factors in patients with respiratory symptoms exposed to hard metals.
Preview · Article · Nov 2005 · Chinese medical journal