摘要
肺黏膜相关淋巴组织淋巴瘤是肺原发淋巴瘤中最常见的类型,其典型影像学表现为肺炎型实变影伴内部支气管扩张。本文报道1例60岁男性患者,临床病程7年余,主要表现为间断咳嗽、咳痰,症状逐渐加重并出现活动后气短、低氧血症,影像学可见双肺多发沿支气管血管束分布的实变影伴周围磨玻璃影,其内可见牵张扭曲支气管充气征,多次呼吸道病原学检测提示合并病毒、细菌感染,但抗感染治疗后病情仅部分好转,肺部实变影呈缓慢进展趋势,最终经支气管镜肺活检确诊为肺黏膜相关淋巴组织淋巴瘤。肺部多发实变影包括感染性疾病、自身免疫性疾病、肿瘤性疾病、肺出血等多种病因,对于病程迁延、久治不愈的肺内实变影,需警惕淋巴瘤等恶性疾病的可能。
Pulmonary mucosa-associated lymphoid tissue lymphoma(MALToma)is the most common type of pulmonary lymphoma.The typical imaging pattern is pneumonia-like consolidation with bronchiectasis.This article reported a case of a 60-year-old male with a disease course of over 7 years.He presented with intermittent cough and sputum,which gradually worsened and were accompanied by dyspnea on exertion and hypoxemia.Chest imaging revealed multiple peribronchovascular consolidation in bilateral lungs,displaying surrounding ground-glass opacities and traction bronchiectasis with air bronchograms.Multiple respiratory pathogen tests suggested co-infections with various viruses and bacteria.However,although the condition partially improved with anti-infective therapy,the pulmonary consolidations showed a slow progression.The final diagnosis of pulmonary MALToma was confirmed by transbronchoscopic lung biopsy.The differential diagnosis of multiple pulmonary consolidations included various causes such as infectious diseases,autoimmune diseases,neoplastic diseases,and pulmonary hemorrhage.For cases with a prolonged clinical course,malignant diseases like lymphomas should be vigilantly considered.
作者
陈茹萱
石钰洁
李芷仪
王婧
邵池
黄慧
Chen Ruxuan;Shi Yujie;Li Zhiyi;Wang Jing;Shao Chi;Huang Hui(Department of Pulmonary and Critical Care Medicine,Chinese Academy of Medical Sciences&Peking Union Medical College Hospital,Beijing 100730,China;Department of Pathology,Chinese Academy of Medical Sciences&Peking Union Medical College Hospital,Beijing 100730,China)
出处
《国际呼吸杂志》
2025年第11期983-987,共5页
International Journal of Respiration
基金
四大慢病重大专项(2023ZD0509500)。
关键词
淋巴瘤
B细胞
边缘区
肺实变
支气管扩张症
肺部感染
Lymphoma,B-cell,marginal zone
Pulmonary consolidation
Bronchiectasis
Pulmonary infection
