Lung disease 35 years after aspiration of activated charcoal in combination with pulmonary lymphangioleiomyomatosis
Lung disease 35 years after aspiration of activated charcoal in combination with pulmonary lymphangioleiomyomatosis
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DOI：
10.1007/s00428-006-0236-z
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发表时间：
2006-08-01
期刊：
影响因子：
3.5
通讯作者：
Lintner, F.
中科院分区：
文献类型：
--
作者：
Huber, M.;Pohl, W.;Lintner, F.
活性炭可以有效治疗大多数有毒物质的摄入。意外吸入活性炭的情况很少见。此前，曾报道过几起与木炭相关的肺部并发症的病例。我们描述了一个在意外吸入活性炭 35 年后出现肺部病变的罕见病例。 38岁女性患者因反复气胸就诊。常规进行的胸部 X 线检查显示肺部病变，高度提示淋巴管平滑肌瘤病 (LAM)。肺组织的组织病理学研究显示了 LAM 的一些特征，但显示出明显的尘肺病变并伴有囊性组织破坏。尘肺反应的特点是明显的黑色沉积物，伴有异物肉芽肿形成和轻微的纤维化。对这些沉积物的扫描电子显微镜研究表明，颗粒的最大直径可达 300 微米。这些颗粒的能量色散 X 射线光谱揭示了富含碳的物质，可能是木炭。误吸事件由临床病史证实。据我们所知，这是第一份不仅针对吸入活性炭后进行长期随访的报告，而且也是针对与 LAM 相结合的木炭相关肺部病变的第一份报告。
Activated charcoal provides effective treatment for most toxic ingestions. Accidental aspiration of activated charcoal is rare. Previously, there have been a few single cases reported on charcoal-related pulmonary complications. We describe an unusual case of pulmonary lesions 35 years after accidental aspiration of activated charcoal. The 38-year-old female patient presented with recurrent pneumothorax. A routinely performed chest roentgenogram revealed pulmonary lesions, highly suggestive to lymphangioleiomyomatosis (LAM). Histopathological investigation of the lung tissue demonstrated some features of LAM but showed prominent pneumoconiotic lesions with cystic tissue destruction. The pneumoconiotic reaction was characterized by prominent black deposits accompanied by foreign-body granuloma formation and minimal fibrosis. Scanning electron microscopic investigation of these deposits showed particles measuring up to 300 mu m in greatest diameter. Energy-dispersive X-ray spectra of these particles revealed carbon-rich material, presumably charcoal. The aspiration event was confirmed by the clinical history. To our knowledge, this is the first report not only on a long-term follow-up after aspiration of activated charcoal but also on charcoal-related pulmonary lesions in combination with LAM.