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目的探讨过敏性肺炎(HP)的临床和病理特点,提高对HP的认识和诊断水平。方法介绍2例亚急性、1例慢性HP的临床病理学改变,并进行相关文献复习。结果 HP根据临床过程分为急性、亚急性和慢性期改变,急性HP的主要病理改变是急性炎症细胞浸润和急性肺损伤;亚急性HP的主要病理特征为淋巴细胞性间质性肺炎、淋巴细胞性细支气管炎和形成不良的肉芽肿,影像学示两侧肺弥漫小叶中心性结节影;慢性HP具有部分亚急性HP改变并伴有间质纤维化,影像学显示纤维化性间质性肺炎改变。结论 HP临床和病理学改变复杂,易与其他病变混淆,需结合临床、影像学及组织学改变才能做出正确诊断。
Objective To investigate the clinical and pathological features of hypersensitive pneumonia (HP) and to improve the understanding and diagnosis of HP. Methods Two cases of subacute and one case of chronic HP were retrospectively reviewed, and the related literatures were reviewed. Results According to the clinical course, HP was divided into acute, subacute and chronic phase changes. The main pathological changes of acute HP were acute inflammatory cell infiltration and acute lung injury. The main pathological features of subacute HP were lymphocytic interstitial pneumonia, lymphocyte Bronchiolitis and the formation of poor granulomas, radiographs showed diffuse central lobe nodules on both sides of the lung; chronic HP with some subacute HP changes associated with interstitial fibrosis, imaging showed fibrosing interstitial Pneumonia changes. Conclusion The clinical and pathological changes of HP are complex and easily confused with other lesions. The diagnosis of HP should be combined with clinical, radiological and histological changes.