摘要
目的对24例临床诊断为间质性肺疾病的患者,通过开胸及胸腔镜肺活检切除标本做病理学检查并结合临床资料进行相关性分析。方法将病理组织经HE及免疫组织化学染色、光镜下观察,并结合临床影像学资料,进行病理组织学分型。结果24例手术切除标本均为非特异性间质性肺炎(NSIP),其中富细胞型10例(41.2%),纤维化型为5例(20.8%),混合型9例(38%)。病理变化为肺间质弥漫性慢性炎,包含浆细胞和淋巴细胞浸润,偶尔可见小灶性肉芽肿,病理变化时相一致。临床影像学均有双肺弥漫性,斑片状间质改变,肺底部病变较为明显。结论诊断NSIP时,应结合临床及免疫学检查以区分寻常性或特发性非特异性间质性肺炎。病理分型(富细胞型、纤维化型及混合型)与本病的预后有重要关系,5年生存率差别较大(富细胞型100%、纤维化型35%、混合型90%)。
Objective To investigate 24 cases of pulmonary interstitial abnormality diagnosed clinically and analyze the relationship between pathological findings and clinical features. Methods Twenty-four cases of operational samples were fixed by formalin and alcohol, dehydrated by bimethanol-benzol, stained by HE（hematoxylin and eosin） and immunohistochemistry. All slides were observed microscopically and subdivided pathologically according to morphological findings and clinical radiological features. Results Twenty-four cases of operational samples were histopathologically diagnosed as nonspecific interstitial pneumonia （NSIP）and subdivided into 3 types：cellular type （10 cases,41.2%）;fibrosing type（5 case, 20.8%） ;mixed type（9 cases, 38 % ）. Histopathological changes were uniformly pulmonary interstitial infiltrates composed of plasma ceils and lymphocytes, as well as occasionally granulomas. Radiologically, a diffuse or patchy bilateral pattern of interstitial abnormality, most prominent in the lower lung fields, was characteristic. Conclusion Histopathological observation and criteria play a key role in diagnosis of nonspecific interstitial pneumonia. The pathological diagnosis of NSIP will be directory to clinical treatment. The prognosis of NSIP is up to pathological subdifferentiation,because the 5-year surviving rates of 3 types are different：cellular type 100% ,mixed type 90% ,and fibrosing type 35 %.
出处
《哈尔滨医科大学学报》
CAS
北大核心
2008年第1期89-90,F0003,共3页
Journal of Harbin Medical University
关键词
非特异性间质性肺炎
富细胞型
纤维化型
混合型
nonspecific interstitial pneumonia
cellular type
fibrosing type
mixed type
