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find Keyword "机化性肺炎" 15 results
  • Cryptogenic Organizing Pneumonia Featured by Mass and Cavity: A Case Report and Literature Review

    ObjectiveTo retrospectively analyze the clinical,pathological and imaging features of one case pathologically diagnosed as cryptogenic organizing pneumonia(COP) to improve clinical diagnosis and treatment. MethodsWith a case report and review of the related literatures,the clinical manifestations,radiological features,pathological features,differential diagnosis,management and prognosis of COP were discussed. ResultsThe clinical manifestations of COP had no specificity. The imaging manifestations were real shadows,ground glass shadows,nodules and all kinds of tape. Pathological features of lung specimen biopsy showed buds of granulation tissue within alveolar ducts and alveoli consisting of fibroblasts. Remarkable response to corticosteroids was found in this patient. The prognosis of COP was good. ConclusionsCOP is diagnosed on basis of clinical,pathologic,and imaging findings. The radiological features of COP which show mass with cavity are rare. It can be easy misdiagnosed as lung infection or tumor. The effects of ordinary anti-bacteria therapy are limited,while the corticosteroids therapy shows preferable effects. Therefore,it's important to acquire pathological evidences as early as possible to guide the diagnose and treatment.

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  • Clinical analysis on 33 patients with cryptogenic organizing pneumonia

    ObjectiveTo improve clinicians' awareness of cryptogenic organizing pneumonia (COP).MethodsThirty-three inpatients with COP, who had been diagnosed by pathology in Nanjing Drum Tower Hospital during January 2013 to December 2016 were collected. Their clinical manifestations, laboratory tests and imaging data were reviewed and analyzed retrospectively.ResultsThirty-three cases consisted of 18 males and 15 females, and the mean age was (58.7±13.5) years old. Most patients had subacute or insidious onset. The common symptoms were cough, fever, shortness of breath and chest tightness. About half of patients revealed inspiratory crackles or velcroes. Autoantibodies and anti-neutrophil cytoplasmic antibodies were negative. High-resolution computerized tomography findings of COP included bilateral patchy areas of air-space consolidation that showed predominantly subpleural or peri-bronchovascular distribution, focal nodules, enlarged hilar or mediastinal lymph nodes and pleural effusion. 25 patients were treated with glucocorticoid, 6 with macrolid, and 2 were only followed up without drug treatment.ConclusionsClinical manifestations, laboratory tests and imaging features are important clues to diagnose COP. Diagnosis depends on pathology. Meanwhile, definite pathogen and potential underlying diseases must be excluded.

    Release date:2018-09-21 02:39 Export PDF Favorites Scan
  • 隐源性机化性肺炎的临床特点分析

    目的 分析62例经病理确诊的隐源性机化性肺炎患者,总结隐源性机化性肺炎的临床表现、实验室检查、影像学、病理学等特点,加深临床医师对隐源性机化性肺炎的认识。方法 收集2019年3月1日—2023年5月31日于首都医科大学附属北京胸科医院住院,经病理诊断为隐源性机化性肺炎的患者的临床资料,回顾性分析其临床表现、实验室检查、影像学资料等。结果 62例患者中男53例,女9例,平均年龄(60.26±9.91)岁。症状以咳嗽、咳痰多见,部分患者伴有发热、咯血、呼吸困难。胸部CT表现为肺部实变、斑片、结节影等,病变多位于胸膜下,可伴有支气管充气征、胸腔积液、胸膜增厚,以及纵隔、肺门淋巴结肿大等。肺功能可能表现为阻塞性通气功能障碍、限制性通气功能障碍及弥散异常等。结论 隐源性机化性肺炎的临床特征、实验室检查及影像学表现缺乏特异性,常需与肺部感染、恶性肿瘤进行鉴别,确诊需病理学支持。

    Release date:2024-05-16 01:48 Export PDF Favorites Scan
  • Sweet 综合征伴机化性肺炎一例报告及文献复习

    目的 提高临床医生对Sweet 综合征合并血液病、肺部疾病的认识, 探讨血液病合并 Sweet综合征的临床特征。方法 报告1 例Sweet 综合征并机化性肺炎、骨髓增生异常综合征的病例, 并作文献复习。结果 血液病合并Sweet 综合征是一种全身性、多系统性疾病, 除皮损外尚可侵犯其他器官, 如肺脏、肝脏、脾脏、肌肉、关节等。结论 报告1 例经活检由病理诊断的Sweet 综合征同时侵犯肺脏引起机化性肺炎的病例, 在糖皮质激素治疗皮损的同时应积极治疗血液病。

    Release date:2016-09-13 04:07 Export PDF Favorites Scan
  • Acute Fibrinous and Organizing Pneumonia: Two Cases Report and Literature Review

    Objective To highlight the characteristics of acute fibrinous and organizing pneumonia ( AFOP) . Methods The clinical, radiological and pathological data of two patients with AFOP were analyzed, and relevant literature was reviewed. Results Two male patients with the age of 48 years and 43 years presented with fever, cough, dyspnea and chest pain. The chest CT scan revealed multiple, bilateral, patchy consolidation distributing in peripheral areas in one case and consolidation in the middle lobe of the right lung and a little pleural effusion in another case. Two patients were diagnosed initially as community acquired pneumonia, but antibiotic treatment was ineffective. After the transbronchial lung biopsy and computed tomography guided percutaneous lung biopsy, pathological examination revealed there were numerous fibrin and organizing tissue in the alveoli without pulmonary hyaline membrane, which were consistent with AFOP. The patients showed significant clinical and radiological improvement after corticosteroid therapy. One patient was stable and the other one died of respiratory failure because of relapse during dose reduction of corticosteroids. Conclusions Patients of AFOP were misdiagnosed as pneumonia easily. Treatment with corticosteroids could be effective to some patients. If the antibiotic treatment was ineffective to the patient with fever and consolidation in the lungs, AFOP should be considered in the differential diagnosis.

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  • 成人Still病伴机化性肺炎一例

    成人Still病(AOSD)是一种原因不明的慢性系统性炎性疾患,属于全身性幼年型类风湿性关节炎的成人变异型,其主要临床表现为高热、多关节疼痛或肿胀、皮疹和中性粒细胞为主的白细胞增多,可累及多个系统。其临床表现复杂多变并凶险,缺乏临床特征,因而误漏诊率很高。现将我院最近收治的1例成人Still病伴继发性机化性肺炎报告如下,以引起临床医师的重视

    Release date:2016-09-14 11:53 Export PDF Favorites Scan
  • 鹦鹉热衣原体肺炎并发机化性肺炎一例并文献复习

    目的 阐述鹦鹉热衣原体肺炎并发机化性肺炎的临床特点、诊治要点及可能机制。方法 报道鹦鹉热衣原体肺炎并发机化性肺炎1例。并以“鹦鹉热衣原体”和“机化性肺炎”为检索词,检索中国知网、 万方、维普数据库,以“psittacosis”或“Chlamydia psittaci”和“organizing pneumonia”为检索词,检索PubMed 数据库。结果 该鹦鹉热衣原体肺炎并发机化性肺炎患者主要表现为咳嗽、咳痰伴持续高热,外院给予喹诺酮治疗后病情仍进展,行肺泡灌洗液宏基因组测序检出鹦鹉热衣原体,并经冷冻肺活检病理示机化性肺炎,给予抗感染联合激素治疗后病情好转,复查胸部CT病灶较前明显吸收,患者最终好转出院。国内外有两篇报道,一篇文献报道1例严重鹦鹉热衣原体肺炎可疑发展为机化性肺炎,另一篇报道从病理学角度证实了鹦鹉热衣原体感染后并发机化性肺炎。结论 鹦鹉热衣原体肺炎在临床上易被漏诊,易发展为重症,可并发机化性肺炎,目前机制尚不十分明确,可能考虑与宿主免疫力低下、特殊感染等相关。

    Release date:2024-02-22 03:22 Export PDF Favorites Scan
  • Clinicoradiologic features of cryptogenic organizing pneumonia

    Objective To analyze the clinical presentations and radiological characteristics of pathologically proved cases of cryptogenic organizing pneumonia(COP).Methods The clinical and radiological features of 8 patients with COP confirmed by open lung biopsy were analyzed.Treatment and follow-up data were also recorded.Results There were 5 male an 3 female patients aged 37 to 68 years.Dyspnea,cough and inspiratory crackles were the most common symptoms and signs.Various computed tomography findings including ground glass opacities,pathy consolidation with air bronchograms,nodules and reticulation were simultaneously observed in the same patient.The diagnostic imaging features of COP were patchy or lobar consolidation,often by a predominantly subpleural distribution,and irregular band-like opacities distributed along the bronchovascular bundle or located in the subpleural area.All patients were treated with corticosteroids and yielded significant improvement in seven cases.Conclusions COP could be diagnosed by clinical and radiological findings and histopathological examination was needed for confirmed diagnosis.In general,COP responds well to glucocorticoid therapy and has a benign prognosis.

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
  • Clinical characteristics of amyopathic dermatomyositis with organizing pneumonia

    ObjectiveTo analyze the clinical characteristics of patients with amyopathic dermatomyositis with organizing pneumonia (ADM-OP).MethodsThe clinical data of 8 patients hospitalized with ADM-OP from June 2014 to June 2018 were retrospectively reviewed and simultaneously compared with those of 8 patients of cryptogenic organizing pneumonia (COP).ResultsThe incidence of skin lesion, Gottron’s sign, mechanic’s hand and positive anti-synthase antibodies in the ADM-OP patients were 87.5%, 87.5% 75.0% and 87.5% respectively. Gender, smoking, respiratory symptoms and signs, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide and treatment strategy were no statistical difference between ADM-OP and COP patients, but the onset age and Chest CT fibrosis scores (CTFS) on admission existed differences. After treatment for 3 months, CTFS, rate of change and forced vital capacity (FVC) existed differences. After treatment for 6 months, CTFS, rate of change, FVC and diffusing capacity of the lung for carbon monoxide existed differences.ConclusionsSkin lesion, Gottron’s sign, mechanic’s hand and positive anti-synthase antibodies are more common in ADM-OP patients. Their response to treatment is good but the improvement rates in CTFS and pulmonary function are slower than those of COP patients.

    Release date:2019-03-22 04:20 Export PDF Favorites Scan
  • Comparison of airspace consolidation in thoracic CT between organizing pneumonia and community acquired pneumonia

    ObjectiveTo explore the differential diagnosis value of airspace consolidation in thoracic CT between organizing pneumonia (OP) and acquired community pneumonia (CAP).MethodsA retrospective study was taken by retrieving the patients CT database from October 2010 to August 2016. Fifty-six consecutive patients with OP and 99 consecutive patients with CAP whose CT showed airspace consolidation were enrolled and their clinical characteristics and radiological characteristics were analyzed.ResultsThe percentage of patients whose CT image showed various amount of air bronchogram (ABG) with different shapes is higher in OP group than that in CAP group (87.5% and 72.7% respectively, χ2=4.558, P=0.033). The median and interquartile range amount of ABG in the OP patients were significantly higher than those in CAP group [4 (ranged from 2 to 8) and 2 (ranged from 0 to 4) respectively, z=3.640, P=0.000]. Morphologically, 58.9% of the OP patients showed entire air bronchogram (EABG) on the thoracic CT, significantly higher than that in CAP group (21.2%) (χ2=22.413, P=0.000). Interrupted ABG was found in 26.3% of CAP patients, while 16.1% of OP patients shared same features and the difference was not statistically significant (χ2=2.125, P=0.148). Traction bronchiectasis and ground glass opacity (GGO) were more likely to be found in the OP patients rather than CAP patients with 26.8% and 39.3% respectively, while they were found in 1.0% and 11.1% in the CAP patients (P<0.05). Reversed halo sign was found only 1.0% of the CAP patients, significantly lower than that in OP group, 26.8% (χ2=25.671, P=0.000). Pleural effusion and bronchial wall thickening were more commonly found in the CAP group with 56.6% and 35.4% respectively. By multivariate logistic analysis, EABG (OR=5.526, P=0.000), traction bronchiectasis (OR=21.564, P=0.010), GGO (OR=4.657, P=0.007) and reversed halo sign (OR=13.304, P=0.023) were significantly associated with OP, while pleural effusion (OR=0.380, P=0.049) and bronchial wall thickening (OR=0.073, P=0.008) were significantly associated with CAP. Other features in thoracic CT coexisting with ABG all reach significance statistically between the OP and CAP group (all P<0.05).ConclusionsAirspace consolidation in thoracic CT may be valuable for the differential diagnosis between OP and CAP. EABG is more commonly found in OP patients than in CAP patients. When EABG exists or ABG coexists with traction bronchiectasis, GGO and reversed halo sign, a diagnose of OP should be considered.

    Release date:2018-05-28 09:22 Export PDF Favorites Scan
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