Abstract：
BACKGROUND: Hypersensitivity pneumonitis (HP) is a common type among all the interstitial lung diseases, and transbronchial lung cryobiopsy is an alternative diagnostic technique for interstitial lung diseases. In this study, we describe the clinical and pathological features of fibrotic hypersensitivity pneumonitis diagnosed with transbronchial lung cryobiopsy (TBLC).
METHODS: A total of 46 diffused parenchyma lung disease (DPLD) patients received TBLC were included in this study. Medical records including medical history spirometry examinations, 6-min walk test (6MWT) results, high resolution computed tomographic (HRCT) scans, BAL, and histopathology were collected. Results of HRCT and histopathology were compared and classified, especially.
RESULTS: Sixteen patients were diagnosed with fibrotic HP, the mean age of whom was 56.3 ± 12.1 years, and 62.5% of them were male. Three of the 16 patients had been misdiagnosed as tuberculosis and received antituberculosis medications, five patients had been diagnosed as unclassifiable pulmonary fibrosis, and five patients had been diagnosed as idiopathic pulmonary fibrosis (IPF). Thirteen (81.3%) patients had a normal lymphocyte count in BAL. The pathological features of usual interstitial pneumonia (UIP) were detected in 11 (68.8%) of the cases, poor defined granulomatous was detected in nine (56.3%) of the cases, and bronchiolocentric fibrosis was detected in two (12.5%) of the 16 cases.
CONCLUSIONS: Fibrotic hypersensitivity pneumonitis should be included in differential diagnosis of pulmonary fibrosis. Pathological characteristics of fibrotic hypersensitivity pneumonitis could be demonstrated from cryobiopsy lung tissue. TBLC is recommended as an alternative diagnostic technique, which may improve the specificity of hypersensitivity pneumonia detection, and UIP is the most frequent pathological finding.
METHODS: A total of 46 diffused parenchyma lung disease (DPLD) patients received TBLC were included in this study. Medical records including medical history spirometry examinations, 6-min walk test (6MWT) results, high resolution computed tomographic (HRCT) scans, BAL, and histopathology were collected. Results of HRCT and histopathology were compared and classified, especially.
RESULTS: Sixteen patients were diagnosed with fibrotic HP, the mean age of whom was 56.3 ± 12.1 years, and 62.5% of them were male. Three of the 16 patients had been misdiagnosed as tuberculosis and received antituberculosis medications, five patients had been diagnosed as unclassifiable pulmonary fibrosis, and five patients had been diagnosed as idiopathic pulmonary fibrosis (IPF). Thirteen (81.3%) patients had a normal lymphocyte count in BAL. The pathological features of usual interstitial pneumonia (UIP) were detected in 11 (68.8%) of the cases, poor defined granulomatous was detected in nine (56.3%) of the cases, and bronchiolocentric fibrosis was detected in two (12.5%) of the 16 cases.
CONCLUSIONS: Fibrotic hypersensitivity pneumonitis should be included in differential diagnosis of pulmonary fibrosis. Pathological characteristics of fibrotic hypersensitivity pneumonitis could be demonstrated from cryobiopsy lung tissue. TBLC is recommended as an alternative diagnostic technique, which may improve the specificity of hypersensitivity pneumonia detection, and UIP is the most frequent pathological finding.
摘要：
背景：过敏性肺炎（HP）是所有间质性肺病中的常见类型，经支气管肺冷冻活检是间质性肺病的替代诊断技术。在这项研究中,我们描述了经支气管镜肺冷冻活检（TBLC）诊断的纤维化过敏性肺炎的临床和病理特征。
方法：共有46例弥漫性肺实质疾病（DPLD）患者接受TBLC纳入本研究。医疗记录，包括病史肺活量测定检查，6分钟步行试验(6MWT)结果,高分辨率计算机断层摄影(HRCT)扫描,BAL,并收集组织病理学。对HRCT和组织病理学结果进行比较和分类,尤其是。
结果：16例患者被诊断为纤维化HP，平均年龄为56.3±12.1岁，其中62.5%为男性。16名患者中有3人被误诊为肺结核,接受了抗结核药物治疗,五名患者被诊断为无法分类的肺纤维化，5例患者被诊断为特发性肺纤维化（IPF）。13例（81.3％）患者的BAL淋巴细胞计数正常。11例(68.8%)患者病理表现为普通型间质性肺炎(UIP),在9例（56.3%）病例中发现了明显的肉芽肿，16例中有2例（12.5％）检测到以细支气管为中心的纤维化。
结论：纤维化过敏性肺炎应纳入肺纤维化的鉴别诊断。从冷冻活检肺组织可以证明纤维化过敏性肺炎的病理特征。建议使用TBLC作为替代诊断技术，这可以提高过敏性肺炎检测的特异性，UIP是最常见的病理发现。
方法：共有46例弥漫性肺实质疾病（DPLD）患者接受TBLC纳入本研究。医疗记录，包括病史肺活量测定检查，6分钟步行试验(6MWT)结果,高分辨率计算机断层摄影(HRCT)扫描,BAL,并收集组织病理学。对HRCT和组织病理学结果进行比较和分类,尤其是。
结果：16例患者被诊断为纤维化HP，平均年龄为56.3±12.1岁，其中62.5%为男性。16名患者中有3人被误诊为肺结核,接受了抗结核药物治疗,五名患者被诊断为无法分类的肺纤维化，5例患者被诊断为特发性肺纤维化（IPF）。13例（81.3％）患者的BAL淋巴细胞计数正常。11例(68.8%)患者病理表现为普通型间质性肺炎(UIP),在9例（56.3%）病例中发现了明显的肉芽肿，16例中有2例（12.5％）检测到以细支气管为中心的纤维化。
结论：纤维化过敏性肺炎应纳入肺纤维化的鉴别诊断。从冷冻活检肺组织可以证明纤维化过敏性肺炎的病理特征。建议使用TBLC作为替代诊断技术，这可以提高过敏性肺炎检测的特异性，UIP是最常见的病理发现。
