肺组织活检术对弥漫性间质性肺疾病诊断价值的临床研究

目的 评价肺组织活检术在弥漫性间质性肺疾病中的诊断价值。方法 回顾性分析1997年7月-2002年12月在我院住院治疗的17例行肺活检术的间质性肺疾病患者临床资料。结果 17例患者均获病理确诊,其中结节病3例,肺泡蛋白沉积症2例,普通型间质性肺炎1例,闭塞性细支气管炎伴机化性肺炎1例,非特异性间质性肺炎1例,Castleman病(浆细胞型)1例,淋巴管平滑肌瘤病1例,肺泡细胞癌2例,类风湿性关节炎肺间质纤维化合并肺鳞癌伴肺内多发转移1例,肺淋巴管癌2例,肺鳞癌伴肺内淋巴管转移1例,肺原发性副神经节细胞瘤1例。结论 肺活检术获取肺组织是弥漫性间质性肺疾病、不典型肺疾病或罕见疑难病症最直接的诊断方法,对常规、胸部高分辨CT检查等未能确诊的病例,具有较高的诊断价值。

Clinical investigation of application of lung biopsy in the diagnosis of diffuse pulmonary interstitial disorders

Objective To evaluate the application of lung biopsy in the diagnosis of diffuse pulmonary interstitial disease (DPID). Methods The data of lung biopsy from 17 cases with uncertain DPID obtained during the period of July 1997 and December 2002 were retrospectively analysed. Results All the cases were diagnosed by pathology. Three of them were diagnosed as sarcoidosis. Two were pulmonary alveolar proteinosis. One with usual interstitial pneumonia (UIP), one with bronchialitis obliterous and organizing pneumonia, one with nonspecific pneumonia, one with Castleman's disease, one with pulmonary lymph angioleiomyomatosis, two with bronchioalveolar carcinoma, one as rheumatoid pulmonary fibrosis complicated with pulmonary squamatous cancer and locally metastas is in lungs, two as pulmonary lymphangitic carcinomatosis, one as lung squamatous cancer with pulmonary lymphangitic metastasis, and one with primary pulmonary paraganglioma. Conclusion Harvest of lung tissue directly by biopsy could be the most useful diagnostic method for DPID, and it is a highly valuable diagnostic tool for those patients whose diagnosis is uncertain with routine chest film and high resolution computed tomography.