The Pathologist's Approach to Acute Lung Injury
The Pathologist's Approach to Acute Lung Injury
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DOI：
10.1043/1543-2165-134.5.719
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发表时间：
2010-05-01
影响因子：
4.6
通讯作者：
Beasley, Mary Beth
中科院分区：
文献类型：
--
作者：
Beasley, Mary Beth
背景：急性肺损伤和急性呼吸窘迫综合征是肺部发病率的重要原因，通常是致命的。从临床角度来看，这两个实体都有精确的定义。组织学上，临床急性肺损伤患者通常表现为弥漫性肺泡损伤，但偶尔也会遇到其他组织学类型，如急性纤维素性和机化性肺炎、急性嗜酸性肺炎和毛细血管炎弥漫性出血。目的：回顾与急性肺损伤临床表现相关的各种组织学类型的诊断标准，并提供诊断辅助和讨论鉴别诊断。资料来源：本综述来自相关同行评议的文献和作者的个人经验。结论：急性肺损伤仍然是发病率和死亡率的重要原因。病理学家应了解肺疾病的组织学类型，而不是弥漫性肺泡损伤，这与急性肺损伤的临床表现有关。确定这些可供选择的组织学发现，以及确定潜在的病原体，特别是感染，可能会影响患者的治疗和疾病的结果。2010；134：719-727)
Context.-Acute lung injury and acute respiratory distress syndrome are significant causes of pulmonary morbidity and are frequently fatal. These 2 entities have precise definitions from a clinical standpoint. Histologically, cases from patients with clinical acute lung injury typically exhibit diffuse alveolar damage, but other histologic patterns may occasionally be encountered such as acute fibrinous and organizing pneumonia, acute eosinophilic pneumonia, and diffuse hemorrhage with capillaritis.Objective.-To review the diagnostic criteria for various histologic patterns associated with a clinical presentation of acute lung injury and to provide diagnostic aids and discuss the differential diagnosis.Data Sources.-The review is drawn from pertinent peer-reviewed literature and the author's personal experience.Conclusions.-Acute lung injury remains a significant cause of morbidity and mortality. The pathologist should be aware of histologic patterns of lung disease other than diffuse alveolar damage, which are associated with a clinical presentation of acute lung injury. Identification of these alternative histologic findings, as well as identification of potential etiologic agents, especially infection, may impact patient treatment and disease outcome.(Arch Pathol Lab Med. 2010; 134: 719-727)