最新成年人巨细胞病毒性肺炎case.ppt

成年人巨细胞病毒性肺炎 ——影像学及病理学表现 胸组读片 2010-03-02 刘晶华 Case Name：Me Ping Sex：Female Age：46 P No.： Case Examine Date 2009-08-17 Thin-section (1-mm collimation) computed tomographic (CT) scan shows Bilateral diffuse ground-glass attenuation with thickened interlobular septa, and A lobular distribution, segmental consolidation with the “inflated bronchia” sign. There are several lymph nodes in the mediastina. No pleural effusion. The heart, liver, spleen and other scanned areas are normal. Case Diagnosis: Bilateral diffuse lesion of lung, considered as infection. Differentiate Diagnosis： (1)Viral pneumonia(CMV,EBV) (2)PCP (3) Chlamydia pneumonia 免疫正常及免疫缺陷患者常见的病毒感染 免疫正常患者 流感病毒 汉坦病毒 EB病毒 腺病毒 免疫缺陷患者 单纯疱疹病毒 水痘-带状疱疹病毒 巨细胞病毒 麻疹病毒 腺病毒 ?Photomicrograph (original magnification, ×100; hematoxylin-eosin stain) of a lung biopsy specimen from a 36-year-old man with pneumonia due to herpes simplex virus type 1 shows a fibrous exudate (large arrows) along the alveolar walls. Note the interstitial thickening due to fibroblastic proliferation (small arrows). ? Pneumonia due to influenza virus (type C) in a 46-year-old man with dyspnea. Initial chest radiograph shows diffuse reticulonodular areas of increased opacity in both lungs. ? Pneumonia due to influenza virus (type C) in a 46-year-old man with dyspnea. Follow-up chest radiograph obtained 15 days later shows progression of the extent of disease with diffuse consolidation throughout both lungs.  ? Pneumonia due to influenza virus (type C) in a 46-year-old man with dyspnea. Thin-section (1-mm collimation) computed tomographic (CT) scan obtained 1 day after the second chest radiograph at the level of the aortic arch shows diffuse ground-glass attenuation with some irregular linear areas of increased attenuation in both lungs. 成年人病毒性肺炎 流感病毒、麻疹病毒、汉坦病毒、腺病毒、单纯疱疹病毒、水痘-带状疱疹病毒、巨细胞病毒以及EB病毒等多种病毒能够引起成年人下呼吸道感染。 成年