Multinodule abnormalities of the tracheobronchus: bronchoscopy findings and clinical diagnosis
Multinodule abnormalities of the tracheobronchus: bronchoscopy findings and clinical diagnosis
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DOI：
10.1111/crj.12356
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发表时间：
2017-07-01
影响因子：
1.7
通讯作者：
Li, Yuan-Yuan
中科院分区：
文献类型：
--
作者：
An, Jian;Yang, Hua-Ping;Li, Yuan-Yuan
支气管镜检查是诊断呼吸系统疾病的重要手段。多发性气管支气管结节很少报道，其原因尚不清楚。ObjectivesThe的目的是本研究的目的是描述的临床特点，多结节气管支气管镜下发现的异常引起的不同diseases. MethodsEighty多发性气管支气管结节患者参加了这项研究。根据我院病理结果，对多发性结节病变及患者的特征进行了诊断。结果55例经病理确诊的患者中，结核肉芽肿16例（29%），结核肉芽肿23例（22%），结核肉芽肿16例（22%）恶性肿瘤占41.8%，诊断为气管支气管病骨软骨增生症2例（21.8%）;结节病10例（3.6%），淋巴瘤1例（1.8%），真菌感染1例（1.8%）。慢性炎症32例。结节分布与病理诊断无关。恶性结节通常较小，外观苍白，而结节较大，光滑，完整的粘膜通常变成不明原因的肉芽肿。结论使用支气管镜观察到的mutinoasthenosis病变的主要原因是肿瘤和结核病。气管支气管内多发结节提示肺部病变，应行活检。恶性结节可以通过外观和活检来诊断。结核病、结节病和真菌感染的病理结果可以是不明原因的肉芽肿。进一步诊断需要其他临床资料。
Background and AimsBronchoscopy is an important method for diagnosing respiratory disease. Multiple tracheobronchial nodules are rarely reported and their causes remain unclear.ObjectivesThe aim of this study was to describe the clinical characteristics of multiple nodule tracheobronchial abnormalities found under bronchoscopy caused by different diseases.MethodsEighty-seven patients with multiple tracheobronchial nodules were enrolled in this study. The characteristics of the multinodule lesions and the patient were diagnosed based on the pathology findings in our hospital. Chest computed tomography images were retrospectively reviewed by pulmonologists and radiologist.ResultsIn 55 patients with definite pathological diagnosis, 16 (29%) patients were diagnosed as tuberculosis (TB) granuloma; 23 (41.8%) cases were diagnosed as malignant disease; 12 (21.8%) cases were diagnosed as tracheobronchopathia osteochondroplastica; 2 (3.6%) cases were diagnosed as sarcoidosis; and one case (1.8%) was diagnosed as lymphoma and one case (1.8%) as fungal infection. There were 32 cases of chronic inflammation. There was no relationship between nodule distribution and the pathological diagnosis. Malignant nodules usually smaller with a pale outlook, while nodules with larger size and smooth and intact mucosa usually turn out to be granuloma of unknown reason.ConclusionThe major causes of mutinodule lesions observed using bronchoscopy are tumor and TB. The presence of multiple endotracheobronchial nodules suggest that pulmonary lesion is present, and biopsy should be performed. Malignant nodules can be diagnosed by appearance and biopsy. Pathology results of TB, sarcoidosis and fungal infection can turn out to be granuloma of unknown reason. Further diagnosis needs other clinical materials.