特发性肺含铁血黄素沉着症的X线诊断(附33例分析)

目的提高对特发性肺含铁血黄素沉着症(以下简称IPH)X线征象的认识,减少误诊。材料与方法对痰内、胃液内找到含铁血黄素巨噬细胞的33例的X线表现综合分析,讨论其X线分型与临床分期的关系及其病理基础。结果一型(隐匿型)相当于临床较早静止期,仅见肺纹理稍增强;二型(毛片型)相当于急性出血期,多表现为双肺中下野毛玻璃状、片状影、心膈角区不透亮;三型(细网型)属临床出血吸收期,多为细网影,同时伴面纱影;四型(网结型)相当于慢性反复发作期,双肺弥漫分布网结状、粟粒状阴影、心影增大;五型(复合型)相当于临床反复发作后遗期,X线表现为以上各型之和。结论X线胸部平片及结合临床资料完全可以诊断本病。

X-ray diagnosis of idiopathic pulmonary hemosiderosis(report of 33 cases)

Purposes To deepen our understanding of idiopathic pulmonary hemosiderosis(IPH)and reduce misdiagnosis'Ma- terials and methods A comprehensive analysis of the X- ray manifestations was made in 33 patients.The relationship and pathologic foundation between the X- ray typing and clinical stages were discussed and the X- ray diagnostic main points were found out. Re- sults Type 1(the latent type)was equal to the clinical earlier resting stage.The stronger lung markings were only seen. Type 2(the hair flake type)was ed to the acute aemorrhagic stage,showing the ground - glass appearance and patchy shadow in the middle and lower fields of the bilateral lungs and not being bright in the cardio-diaphragmatic angle area.Type 3(the thin net type)belonged to the bleeding absorptive stage of the clinical early and middle stages,shawing the thin net shadow,also with the veil shadow. Type 4 (the net knot type)was equal to the chronic repeated attack stage,stage the diffuse distribution net knot and miliary shadow in the bilateral lungs,The heart shadow enlarged. Type 5(the complex type)was equal to the sequel stage of the clinical repeated attack, showing all the manifestations mentioned above.Conclusion The disease can completely be diagnosed with the method of combining the X- ray chest plain film and the clinical data.