脂质性肺炎3例并文献复习

发布时间：2018-08-18 12:03

【摘要】：目的探讨脂质性肺炎的临床病理学特征。方法回顾性分析3例脂质性肺炎的临床病理学特征、诊断及鉴别诊断等并复习相关文献。结果男性1例,女性2例,年龄分别为73岁、34岁和53岁,3例既往均有手术史,详细追问获得油剂使用史。因咳嗽、咳痰或发热就诊。影像学上2例分别记录为两肺散在多发磨玻璃影,两肺见片状和小斑点状密度增高影,1例右肺可见散在条片状和高密度结节影。镜下均可见肺泡腔内聚积大量组织细胞,组织细胞胞质空亮,胞质内形成网格状分隔,部分肺泡腔呈明显渗出改变,渗出液内散在胞质空亮的组织细胞,可出现肺泡上皮增生。免疫表型:CD68强阳性,六胺银和PAS染色阴性,上皮性标记(CK7、TTF-1、SPA等)示肺泡上皮排列整齐,极性良好。结论脂质性肺炎临床表现和影像学表现均缺乏特异性,易误诊,大量胞质空亮的组织细胞偶有提示诊断的价值,追寻病史有助于病理诊断。
[Abstract]:Objective To investigate the clinicopathological features of lipid pneumonia.Methods The clinicopathological features,diagnosis and differential diagnosis of 3 cases of lipid pneumonia were retrospectively analyzed.Results 1 case was male and 2 cases were female.The ages were 73,34 and 53,respectively.All the 3 cases had operation history in the past.The history of using oil was investigated in detail. Two cases were diagnosed as scattered ground-glass opacity in both lungs, slice-like and spot-like density enhancement in both lungs, and one case with scattered strip-like and high-density nodules in the right lung. The alveolar epithelial hyperplasia was observed in the exudates. Immunophenotype: CD68 was strongly positive, silver hexamine and PAS staining were negative, and epithelial markers (CK7, TTF-1, SPA, etc.) showed that the alveolar epithelium was well arranged and polarity was good. Sex, easy to misdiagnose, a large number of cytoplasmic empty tissue cells occasionally prompt diagnostic value, tracing the history of disease is conducive to pathological diagnosis.
【作者单位】：复旦大学附属中山医院病理科;复旦大学附属中山医院呼吸科;
【基金】：上海市卫计委薄弱科室资助项目(2015ZB0201)
【分类号】：R563.1

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