Respiratory bronchiolitis - A clinicopathologic study in current smokers, ex-smokers, and never-smokers
Respiratory bronchiolitis - A clinicopathologic study in current smokers, ex-smokers, and never-smokers
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DOI：
10.1097/00000478-200205000-00011
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发表时间：
2002-05-01
影响因子：
5.6
通讯作者：
Katzenstein, ALA
中科院分区：
文献类型：
--
作者：
Fraig, M;Shreesha, U;Katzenstein, ALA
本文对156例经手术肺活检证实的109例呼吸性细支气管炎（RB）的临床和病理特点进行了分析。109例病例中共有107例（98%）发生在吸烟者中，包括所有83例当前吸烟者和49例既往吸烟者中的24例（49%）。RB在一些患者戒烟后持续多年，三分之一的患者在戒烟后5年发生，1例患者在戒烟后32年发生。巨噬细胞胞质色素沉着程度与吸烟包年数之间存在相关性，支气管周围纤维化与吸烟包年数之间也存在相关性。肺功能检查结果与病理结果无相关性。在6例患者中观察到脱屑性间质性肺炎样反应。根据脱屑性间质性肺炎和RB相关间质性肺病的临床结果，分别诊断出1例脱屑性间质性肺炎样反应和1例RB患者。无组织学特征区分脱屑性间质性肺炎与脱屑性间质性肺炎样反应或RB相关间质性肺病与RB。5例变异型RB与RB相似，但巨噬细胞胞浆缺乏色素，均发生在从不吸烟者中，其意义尚不清楚。RB是吸烟的准确组织学标志物，并且可能在戒烟多年后发现。没有可靠的组织学特征来区分RB相关间质性肺病与RB或脱屑性间质性肺炎样反应与脱屑性间质性肺炎。
The clinical and pathologic features of 109 cases of respiratory bronchiolitis (RB) identified from review of 156 consecutive surgical lung biopsy specimens were studied. A total of 107 of the 109 cases (98%) occurred in smokers, including all 83 current smokers and 24 of 49 ex-smokers (49%). RB persisted in some patients for many years after stopping smoking, occurring in one third of patients 5 years after quitting, and in one patient 32 years afterwards. A correlation was found between degree of cytoplasmic pigmentation of macrophages and number of pack-years smoked and also between the presence of peribronchiolar fibrosis and number of pack-years. No correlation was found between pulmonary function test results and pathologic Findings. A desquamative interstitial pneumonia-like reaction was observed in six individuals. One patient each with a desquamative interstitial pneumonia-like reaction and one with RB were diagnosed based on clinical findings with desquamative interstitial pneumonia and RB-associated interstitial lung disease, respectively. No histologic features distinguished desquamative interstitial pneumonia from a desquamative interstitial pneumonia-like reaction or RB-associated interstitial lung disease from RB. Five cases of variant RB were encountered that resembled RB except that macrophage cytoplasm lacked pigment, All occurred in never-smokers, and their significance is unknown. RB is an accurate histologic marker of cigarette smoking, and it may be found many years after smoking ceases. There are no reliable histologic features to distinguish RB-associated interstitial lung disease from RB or desquamative interstitial pneumonia-like reactions from desquamative interstitial pneumonia.