肾移植受者卡氏肺孢子肺炎12例临床病理分析

Pneumocystis carinii pneumonia in renal transplantation recipients: a clinical and pathologic analysis

目的 探讨肾移植受者卡氏肺孢子肺炎的临床病理特点.方法 复习12例肾移植受者卡氏肺孢子肺炎的临床病理资料,并对其组织病理学、组织化学进行观察分析.结果 12例均表现为间质性肺炎以及肺泡腔内出现泡沫状或絮状蛋白样渗出物,渗出物与肺泡壁存在明显的空隙,肺泡立方上皮明显增生;六胺银染色见病原体呈黑色圆形或半月形,大小约4～5μm.结论 卡氏肺孢子肺炎是一种间质性肺炎,泡沫状渗出物及查见病原体是其确诊的重要依据.

Objective To study the clinical and pathological characteristics of pneumocystis carinii pneumonia in renal transplantation recipients. Methods We reviewed the clinical and pathological data in 12 renal transplantation recipients with pneumocystis carinii pneumonia, and analysed systematically their histopathological and histoehemical characteristics. Results Among the 12 cases, all were identified as interstitial pneumonia. Pathological features showed foamy or protein exudates filled in alveolar cavity with interstice between the alveolar wall and exudates, proliferation of alveolar cuboidal epithelium, and black circular or semilunar pathogens with 4 - 5 μm diameter presented by Gomori＇s methnanime silvemitmte staining. Conclusions Pneumocystis carinii pneumonia presents as interstitial pneumonia. Foamy exudates and visible pathogens in pathological examination are important features for accurate diagnosis.