Lung biopsy in rheumatoid arthritis.
Lung biopsy in rheumatoid arthritis.
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类风湿性关节炎的肺活检。
DOI：
10.1164/arrd.1985.131.5.770
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
C. B. Carrington
中科院分区：
文献类型：
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作者：
Samuel A. Yousem;Thomas V. Colby;C. B. Carrington
40例类风湿性关节炎和可能的“类风湿性肺病”患者的开放性肺活检进行了回顾，试图将组织学与放射学、生理学和预后变量相关联。各种各样的组织病理学特征，并认识到原发性和继发性损伤的模式。根据组织学模式确定了5个不同的组：肺类风湿结节、普通型间质性肺炎（UIP）、闭塞性细支气管炎伴斑片状机化性肺炎（BOOP）、淋巴样增生和细胞间质浸润。以类风湿性结节为主要表现者预后良好，而UIP表现者预后较差。BOOP患者的预后比UIP患者更好，淋巴样增生和/或非特异性细胞间质浸润患者也是如此。肺功能检查与X线和组织学检查结果之间没有一致的相关性。术语“类风湿性肺病”作为组织学诊断是没有用的，因为它包含了广泛的形态学改变，携带显着不同的病变。
Forty open lung biopsies from patients with rheumatoid arthritis and possible "rheumatoid lung disease" were reviewed in an attempt to correlate histology with radiologic, physiologic, and prognostic variables. A wide variety of histopathologic features was seen, and primary and secondary patterns of injury were recognized. Five different groups based on histologic patterns were identified: pulmonary rheumatoid nodules, usual interstitial pneumonia (UIP), bronchiolitis obliterans with patchy organizing pneumonia (BOOP), lymphoid hyperplasia, and cellular interstitial infiltrates. The finding of rheumatoid nodules as the primary pattern imparted a uniformly good prognosis, whereas the pattern of UIP indicated a poor one. Patients with BOOP had a more favorable prognosis than did patients with UIP, as did patients with lymphoid hyperplasia and/or nonspecific cellular interstitial infiltrates. Consistent correlations between pulmonary function testing and roentgenographic and histologic findings were not found. The term "rheumatoid lung disease" is of no use as a histologic diagnosis because it encompasses a broad spectrum of morphologic changes that carry significantly different prognoses.