2分钟看懂肺病图片解析.docxVIP

2分钟看懂肺病图片解析 《高分辨率肺部CT》,第五版，136页：少量胸膜下和小叶中心性的小结节，可 见于吸烟人群，有研究发现12%-27%的吸烟者有边缘不清楚的小叶中心性结节， 反应可能有细支气管周围纤维化或者呼吸性细支气管炎。 I 1.呼吸性细支气管炎伴间质ttWW (respiratory bronchiolitis-associated interstitial lung disease, RB-ILD) 这个很容易理解，吸烟、呼吸性细支气管炎。吸烟入肺，真的是没有口吸。烟毒 在肺小叶的中心聚集引起磨玻璃结节！真的是：这人间袅袅炊烟，在肺里磨玻璃 玩！ a. b? Figure 1. RB-ILD in a 32-year-old man with a 17 pack-ycar history of smoking who presented with a cough, restrictive PFT results, and reduced diffusion capacity, (a) High-resolution Cl* image obtained through the upper lungs shows bilateral centrilobular ground-glass nodules (arrow)?(b) Photomicrograph of a surgical lung biopsy specimen shows a bronchiolocentric collection of pigmented macrophages (arrow). Figure 1? RB-ILD in a 32-ycar-old man with a 17 pack-year history of smoking who presented with a cough, restrictive PFT results, and reduced diffusion capacity, (a) High-resolution CT image obtained tlirough the upper lungs shows bilateral centrilobular grounglass nodules (arrow), (b) Photomicrograph of a surgical lung biopsy specimen shows a bronchiolocentric collection of pigmented macrophages (arrow). I 2?脱屑性间质性肺炎(desquamative interstitial pneumoniae DIP) 你可以理解为吸烟脱了一层皮，双肺弥漫性病变！ e e 下面这个患者更牛皮，吸烟后引起肺部弥漫性病变，无所谓，继续吸烟。你还别 说，激素治疗3年之后病灶居然吸收了。然而，再过半年，病情恶化！这可不是 无间道，给你三年之后乂三年！更不是医师规范化培训 Figure 3? DIP in a 50-year-old woman wich a 25 pack-year history* of smoking. Smoking coniinued after diagnosis. Corticosteroid therapy was siaried. (a) High-resolution CT image obtained through ilie right lower lung at initial diagnosis shows diftuse ground-glass opacity, (b) High-resolution CT image obiained tlirough the right lower lung 3 years later shows near-complete resolution of the ground-glass opacity, (c) High-resolution CT image obtained 6 inondis later shows txacerbaiion of the DIP witli new dense ground-glass opacity. Arrow = small right pncmnodio- rax. (d) PhoLoniicrograpli of a surgical lung biopsy specimen bhovvs diffuse iiHereiitial chronic iiiilanunation and pigmented macrophages wiih