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外源性过敏性肺泡炎21例病理和临床分析 被引量:8
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作者 罗本涛 宇小婷 易祥华 《同济大学学报(医学版)》 CAS 2015年第3期63-67,共5页
目的探讨外源性过敏性肺炎(extrinsic allergic alveolitis,EAA)的临床病理特点,提高临床和病理的诊断水平。方法回顾性分析经肺活检病理诊断的21例EAA的临床、影像和病理特点并进行随访。结果 21例中女14例、男7例,年龄范围24-79岁... 目的探讨外源性过敏性肺炎(extrinsic allergic alveolitis,EAA)的临床病理特点,提高临床和病理的诊断水平。方法回顾性分析经肺活检病理诊断的21例EAA的临床、影像和病理特点并进行随访。结果 21例中女14例、男7例,年龄范围24-79岁(中位年龄51岁)。14例(66.7%)有过敏原接触史,其中7例为有机和无机物,5例有养猫、狗和鸽子史,2例有羊毛和皮革化纤接触史,4例(19.0%)无明显过敏原接触史,3例(14.3%)不详。主要症状是间断性咳嗽、咳痰、气喘。胸部CT均显示双肺弥漫性或者片状磨玻璃影。13例经电视胸腔镜(VATS)/小切口开胸肺活检、8例经TBLB肺活检,病理形态学表现为细支气管炎、间质淋巴细胞浸润、上皮样细胞或者多核巨细胞聚集(14例,66.7%)、非干酪性上皮样肉芽肿形成(8例,38.1%)。9例(42.9%)分别误诊为细菌性肺炎、肺结核和真菌感染。脱离过敏原和糖皮质激素治疗效果好。结论 EAA的临床和影像表现缺乏特征性,宠物以及其他过敏原接触史对诊断有重要的提示作用;病理组织学上部分患者缺乏特征性的上皮样结节形成,病理诊断需要结合临床和胸部影像学的表现。 展开更多
关键词 过敏性肺炎 外源性过敏性肺泡炎 肺纤维化 诊断
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Clinicopathologic and ultrastructural observation of primary pulmonary cryptococcosis:a study of 37 cases
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作者 罗本涛 易祥华 +4 位作者 罗本芳 芮炜玮 方建萍 朱旭友 朱美芳 《外科研究与新技术》 2010年第1期63-68,共6页
Objective To investigate the pathologic diagnosis and ultrastructure features of primary pulmonary cryptococcosis (PC). MethodsRetrospective analysis was made on 37 cases of PC with histochemical stain and light micro... Objective To investigate the pathologic diagnosis and ultrastructure features of primary pulmonary cryptococcosis (PC). MethodsRetrospective analysis was made on 37 cases of PC with histochemical stain and light microscopy observations. Transmission electron microscopy was performed on 19 cases. ResultsThree of 37 cases were confirmed by fine needle aspiration biopsy while the other 34 patients by open-chest exploratory operation.Pathologic findings: cryptococcosis neoformans (CN) were detected in all cases,2 with gelatinous lesions and 35 non-casating granuloma. The revealing rate of CN with the mucicarmine stain(MC),periodic acid-Schiff stain(PAS), alcian blue (AB) and Grocott methenamine-silver (GMS) was 85.2% (23/27), 97.3% (36/37), 64.9% (24/37) and 96.3% (26/27), respectively. All CNs detected by transmission electron microscopy had capsules and most of them possessed simple structure with undeveloped cellular organelles and cell cataplasia. Some CNs had cellular nucleus, nucleoli, mitochondria and vacuoles. The detective rate of CNs by transmission electron microscope was 89.5 % (17/19). ConclusionAbsent of specific clinical manifestations and radiographic features, fine needle aspiration biopsy and open biopsy remain the chief approaches in the diagnosis of PC. It could be further helpful by using light microscopy and transmission electron microscopy to make definitive diagnosis and differential diagnosis as well as MS, GMC and PAS histochemical staining. 展开更多
关键词 CRYPTOCOCCOSIS PULMONARY CLINICOPATHOLOGY ULTRASTRUCTURE
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