PDF(Pubmed)
Abstract：
The diagnosis of pulmonary alveolar proteinosis (PAP) is based on biopsies. Compared with other methods of taking biopsies, transbronchial lung cryobiopsy (TBLC) has a higher diagnostic rate and the likelihood of pneumothorax. Selective bronchial occlusion (SBO) is an effective technique for treating intractable pneumothorax. However, there are no data available about SBO for the prevention of pneumothorax after TBLC in a PAP patient. A 49-year-old man complained of recurrent cough and tachypnea, and his symptoms did not fully resolve until the diagnosis was confirmed, and he was treated with whole lung lavage. Our patient was ultimately diagnosed with PAP by TBLC but not multiple tests for the bronchoalveolar lavage fluid (BALF). The patient was discharged quickly after whole lung lavage due to the fact that he did not develop pneumothorax under SBO. This case illustrates that TBLC is a supplementary examination for PAP, especially for those in whom BALF results fail to confirm a diagnosis. Moreover, our report highlights that SBO is necessary to effectively prevent pneumothorax during and after multiple TBLCs in PAP patients.
摘要：
肺泡蛋白沉积症（PAP）的诊断基于活检。与其他活检方法相比，经支气管肺冷冻活检（TBLC）具有较高的诊断率和气胸的可能性。选择性支气管阻塞（SBO）是治疗顽固性气胸的有效方法。然而,对于1例PAP患者,目前尚无有关SBO预防TBLC后气胸的数据.一名49岁男子抱怨反复咳嗽和呼吸急促，直到确诊，他的症状才完全缓解，他接受了全肺灌洗治疗。我们的患者最终被TBLC诊断为PAP，但未进行支气管肺泡灌洗液（BALF）的多次检查。由于在SBO下没有发生气胸，患者在全肺灌洗后迅速出院。这种情况说明TBLC是对PAP的补充检查，特别是对于那些BALF结果未能确认诊断的人。此外，我们的报告强调,SBO对于有效预防PAP患者多次TBLC期间和之后的气胸是必要的.
