肺活检对弥漫性肺疾病的诊断价值

Lung Biopsy in Diagnosis of Diffuse Parenchymal Lung Disease

目的探讨肺活检对弥漫性肺疾病的诊断作用。方法对1999年～2006年2月31例肺活检的弥漫性肺疾病患者进行回顾性分析。结果31例患者均获病理确诊,其中普通型间质性肺炎（UIP）8例（其中合并肺腺癌2例）,肺结核5例,腺癌3例。急性间质性肺炎（AIP）、结节病、脱屑性间质性肺炎（合并肺腺癌1例）各2例。隐源性间质性肺炎（COP）、非特异性间质性肺炎（NSIP）、肺组织细胞增生症-X、慢性嗜酸粒细胞性肺炎（CEP）、肺泡蛋白沉着症、韦格纳肉芽肿病（WG）、肺奴卡氏菌病、双肺炎性结节、肺原发性恶性淋巴瘤各1例。结论对常规、支气管镜及肺穿刺活检未能确诊的病例,开胸肺活检作为一种诊断方法,能获得足够的肺组织,具有很高的敏感性和特异性,尤其是一些罕见病和不典型的病例,具有较大的价值。

Objective To evaluate the role of lung biopsy in diagnosis of diffuse parenchymal lung diease. Methods thirty-one patients with diffuse parenchymal lung disease who underwent lung biopsy from 1999 to February 2006 were reviewed. Results The documented pathologic diagnosis in 31 patients with diffuse parenchymal lung disease who underwent lung biopsies were ： 8 UIP, 5 tuberculosis, 3 lung cancer, 2 AIP, 2 scarcoidosis,2 DIP,1 nocardiosis,1 COP,1 NSIP,1 CEP,1 PAP,1 histiocytosis-X, 1 WG. Conclusious Most of these patients did not definitely diagnosed through their clinical evaluation including history, chest X-ray and TBLB （or lung biopsy） . Open lung biopsy, is a useful method, as it is sensitive and specific in diagnosis of diffuse paronchymal lung disease, it is helpful in diagnosing rare and atypical diffuse parenchymal lung disease.