纤维支气管镜在诊断肺真菌病中的应用

目的：探讨纤维支气管镜（纤支镜）下肺真菌病的形态,以及对肺真菌病的诊断价值。方法：对21例肺真菌病患者的临床资料及纤支镜检查结果进行回顾性分析。结果：21例患者临床表现以咳嗽、咳痰最为常见,其次为痰血,发热、胸闷等少见。胸部影像学表现为：肺不张3例,结节影3例,肿块12例,片状及斑片影4例,气管腔内结节影1例。纤支镜下形态学表现为：新生物14例（其中12例表面覆盖灰白坏死物）,气管腔内坏死物5例,管壁黏膜结节样隆起1例,未见明显异常1例。病理结果：均经纤支镜活检病理学确诊为肺真菌病,其中7例明确合并肺癌。结论：纤支镜下肺真菌病的形态学表现多样,且多无特异性,经纤支镜行组织病理学检查,对肺真菌病有较高的诊断价值。

The diagnostic value of fibrobronchoscopy in pulmonary mycosis

Objective： To investigate the morphological manifestation and the diagnostic value of fibrobronchoscopy in pulmonary mycosis. Methods： The clinical data and the fibrobronchoscopy results of 21 cases with pulmonary mycosis were analyzed retrospectively. Results： Twenty-one pulmonary mycosis cases were enrolled,cough or expectoration was the main symptom,followed by hemoptysis,febricity or chest distress rare. Chest imaging results were shown： 3 cases of atelectasis,3 cases of nodules,12 cases of tumor,4 cases of lamellar and patchy shadow and one of endobronchial nodule. The morphological manifestation of fibrobronchoscope were shown that 14 cases with neoplasm（ including 12 neoplasms＇ surface covered with gray necrosis）,5 with sphacelus in tracheal cavity,one with tube wall mucosal nodular eminence,and one patient was no obvious abnormality. Twenty-one cases were confirmed with the diagnosis of pulmonary mycosis by pathology through fibrobronchoscopy biopsy,including 7 cases with lung cancer. Conclusions：There were different morphological manifestations of fibrobronchoscopy in pulmonary mycosis,and no specificity. Obtaining the pathological specimens of lung by fibrobronchoscopy played an important role in the diagnosis of pulmonary mycosis.