Interstitial lung diseases (ILD’s) are a group of heterogenous chronic, ferociously progressive lung diseases. The aetiology of the aforementioned diseases is not always recognisable. The diagnosis of these dismal di...Interstitial lung diseases (ILD’s) are a group of heterogenous chronic, ferociously progressive lung diseases. The aetiology of the aforementioned diseases is not always recognisable. The diagnosis of these dismal diseases is a vivid challenge for the physicians. Through the intervening years different diagnostic algorithms have been implemented towards more accurate outcome. Different types of ILD’s demand diverse diagnostic approaches. In the latest years a novel diagnostic mini invasive approach seems to gain continuously terrain towards the diagnosis of ILD’s. Transbronchial cryobiopsy may be the Holy Grail in the diagnosis of these diseases or a misleading diagnostic tool in this challenging field.展开更多
BACKGROUND Pulmonary alveolar proteinosis(PAP)often presents nonspecifically and can be easily confused with:(1)Idiopathic interstitial lung fibrosis;(2)alveolar carcinoma;(3)pulmonary tuberculosis;and(4)other lung di...BACKGROUND Pulmonary alveolar proteinosis(PAP)often presents nonspecifically and can be easily confused with:(1)Idiopathic interstitial lung fibrosis;(2)alveolar carcinoma;(3)pulmonary tuberculosis;and(4)other lung diseases such as viral pneumonia,mycoplasma pneumonia,and chlamydial pneumonia.CASE SUMMARY Diagnosis:In this case,a patient was diagnosed with PAP through transbronchial cryobiopsy(TBCB)and quantitative metagenomic next-generation sequencing,which confirmed the impairment of surfactant turnover as the underlying cause of PAP.Interventions:High-volume total lung lavage was performed for this patient.Outcomes:The patient's clinical condition had improved significantly by the 6-month follow-up,with a 92%finger oxygen saturation.A repeat chest computed tomography scan revealed scattered patchy ground-glass shadows in both lungs,which was consistent with alveolar protein deposition but with a lower density than in the radiograph from October 23,2022.CONCLUSION TBCB has unique advantages in diagnosing atypical alveolar protein deposition,particularly for enabling the early detection of PAP.This information can help patients take preventive measures to prevent or halt PAP development by avoiding dusty environments and seeking treatment with total lung lavage and inhaled granulocyte macrophage colony-stimulating factor.展开更多
文摘Interstitial lung diseases (ILD’s) are a group of heterogenous chronic, ferociously progressive lung diseases. The aetiology of the aforementioned diseases is not always recognisable. The diagnosis of these dismal diseases is a vivid challenge for the physicians. Through the intervening years different diagnostic algorithms have been implemented towards more accurate outcome. Different types of ILD’s demand diverse diagnostic approaches. In the latest years a novel diagnostic mini invasive approach seems to gain continuously terrain towards the diagnosis of ILD’s. Transbronchial cryobiopsy may be the Holy Grail in the diagnosis of these diseases or a misleading diagnostic tool in this challenging field.
基金Supported by the Joint Project of Chongqing Health Commission and Science and Technology Bureau,No.2022MSXM103.
文摘BACKGROUND Pulmonary alveolar proteinosis(PAP)often presents nonspecifically and can be easily confused with:(1)Idiopathic interstitial lung fibrosis;(2)alveolar carcinoma;(3)pulmonary tuberculosis;and(4)other lung diseases such as viral pneumonia,mycoplasma pneumonia,and chlamydial pneumonia.CASE SUMMARY Diagnosis:In this case,a patient was diagnosed with PAP through transbronchial cryobiopsy(TBCB)and quantitative metagenomic next-generation sequencing,which confirmed the impairment of surfactant turnover as the underlying cause of PAP.Interventions:High-volume total lung lavage was performed for this patient.Outcomes:The patient's clinical condition had improved significantly by the 6-month follow-up,with a 92%finger oxygen saturation.A repeat chest computed tomography scan revealed scattered patchy ground-glass shadows in both lungs,which was consistent with alveolar protein deposition but with a lower density than in the radiograph from October 23,2022.CONCLUSION TBCB has unique advantages in diagnosing atypical alveolar protein deposition,particularly for enabling the early detection of PAP.This information can help patients take preventive measures to prevent or halt PAP development by avoiding dusty environments and seeking treatment with total lung lavage and inhaled granulocyte macrophage colony-stimulating factor.
