胸腺瘤伴弥漫性泛细支气管炎一例报告并文献复习

Diffuse panbronchiolitis complicated by thymoma:a case report and a review of literature

目的 提高对弥漫性泛细支气管炎 (DPB)的认识。方法 对 1例经胸腔镜肺活检病理确诊为DPB患者的临床资料进行分析 ,并结合文献复习。结果 DPB是一种慢性小气道疾病 ,以两肺弥漫性呼吸性细支气管的炎症为特征。DPB的病因及发病机制尚不清楚 ,可能与遗传和免疫因素有关。临床表现为慢性咳嗽、咳痰、活动后气短 ,常合并铜绿假单胞菌感染。如不治疗 ,患者可发展为呼吸衰竭 ,预后不良。结论 遇到不明原因的双肺结节状阴影应想到DPB ,并争取做肺组织活检以明确诊断。

Objective To highlight the characteristics of diffuse panbronchiolitis(DPB). Method(One patient) with DPB confirmed by thorocoscopic biopsy was described and relevant literatures were reviewed. Results DPB is a chronic lower respiratory tract disease common in Japanese, rare in China, characterized by infiltration of inflammatory cells around bronchioles. Although the etiology and precise mechanisms are under investigation, it is commonly hypothesized that heredity and immunity have a major role in DPB. Symptoms include cough, expectoration, and dyspnea after exercises. Pseudomonas aeruginosa is isolated from sputum in some cases. If left untreated, DPB progresses rapidly and has a poor prognosis if respiratory failure occurs. Conclusions DPB should be included in the differential diagnosis of bilateral multiple pulmonary nodular shadows. Long-term, low-dose macrolide therapy may improve the prognosis through an anti-inflammatory effect.