肺原发性霍奇金淋巴瘤临床病理分析

目的 探讨肺原发性霍奇金淋巴瘤的诊断与鉴别诊断.方法 回顾性分析3例肺霍奇金淋巴瘤病例并复习相关文献.结果 3例患者均为男性,以咳嗽症状为主,肿瘤较大,平均直径为5 cm,可伴有肺门及纵隔淋巴结肿大,镜下均可见典型的RS细胞,背景细胞内有较明显嗜酸粒细胞浸润,并见干尸细胞,免疫组化CD15和CD30阳性.化疗、骨髓移植可使病情缓解,长期生存.结论 肺原发性霍奇金淋巴瘤病理学及免疫表型具有一定的特征,恰当的治疗预后良好.     

茶多酚对肺癌SPC-A1细胞增殖的影响

目的 探讨茶多酚对人肺癌SPC-A1细胞增殖的影响.方法 体外培养人肺腺癌SPC-A1细胞,以50～300 mg/L茶多酚作用12、24、36 h后,MTT法测定细胞的增殖活性,琼脂糖凝胶电泳、透射电镜观察细胞凋亡情况,流式细胞仪检测对细胞周期的阻滞作用.结果 茶多酚可抑制肺癌细胞的增殖活性,其抑制作用随时间的延长而增强,以36 h抑制作用最强.浓度50～150 mg/L,抑制作用随浓度增高而增强;浓度＞150 mg/L,抑制作用随浓度增高反而减弱.茶多酚可使肺癌细胞阻滞于G1期,以150 mg/L阻滞作用24 h最强.结论 茶多酚可诱导人肺癌SPC-A1细胞的凋亡,并使细胞周期阻滞于G1期,抑制肺癌细胞的增殖.     

伯氏疟原虫红外期体外培养的研究

本文报告在国内首次建成了胚肺细胞-伯氏疟原虫红外期体外培养系统.用胰酶消化法自人工流产胎儿分离出胚肺细胞后,建立Elu 8801细胞株。斯氏按蚊叮咬伯氏疟原虫ANKA株感染的昆明小鼠18～21d后,在无菌条件下解剖出唾腺,制备子孢子悬液,接种于单层培养的胚肺细胞。培养48h后,可见红外期裂殖体。72h后,部分裂殖体内已形成成熟的裂殖子,将培养上清经腹腔接种健康小鼠,可使之感染疟疾并可经血传感染其它小鼠。用第2代感染小鼠血饲喂按蚊,蚊体内可产生子孢子。表明本室建立的人胚肺细胞林对P.b.ANKA株易感染,并能支持其红外期发育成熟,产生有感染力的红外期裂殖子。     

槐耳清膏对人肺腺癌A549细胞增殖及周期的影响

目的研究槐耳清膏对人肺腺癌A549细胞增殖及周期的影响。方法制备浓度为0、3、6、9 mg/ml的槐耳清膏与人肺腺癌A549细胞作用后,采用流式细胞检测观察细胞凋亡率,并分析药物干预36 h对细胞周期和细胞凋亡率的影响。结果流式细胞术检测结果显示,槐耳清膏各浓度组均可发生细胞凋亡,与对照组相比差异显著(P0.05)。各浓度组可使人肺腺癌A549细胞G0/G1、S期细胞比例减少,G2/M期细胞比例增多。结论槐耳清膏能诱导人肺腺癌A549细胞增殖,可能与细胞被阻滞于G2/M期有关。     

人参皂甙对人胚肺二倍体细胞传代和寿命的影响

用人参提取物做人胚肺二倍体细胞的寿命实验,国内外均有报导,并已证明人参提取物可使二倍体细胞突破体外遗传寿限,延缓细胞的衰老。研究者特别注重观察了人参对细胞群体倍增水平,细胞寿命和增殖率的影响及衰老细胞光镜、电镜形态学     

氧中毒

在正常气压下吸入空气时可产生占耗氧量1～5%的活性氧,其生成量随氧浓度增高而增加.当产生的活性氧超过机体的处理能力时,可使细胞、血管、肺和中枢神经系统遭受损害,发生氧中毒.目前尚缺乏有效的治疗方法,故应以预防为主,最主要的是掌握好吸氧浓度.     

超表达Serrate1树突细胞对支气管哮喘小鼠CD4+CD25+T细胞分化的作用

2组小鼠肺组织的病理学改变.结果 与对照组相比,Serrate1组可使哮喘小鼠脾脏CD4+CD25+T细胞数量明显增多,占CD4+T细胞的百分数亦明显增高;Serrate1组CDZT细胞IL-10、CTLA-4、TGFβ1 mRNA表达明显增强,且气道炎症明显减轻.结论 超表达Serrate1 DC能抑制哮喘小鼠CD4+T细胞分化和促进CD4+T细胞分泌抑制性细胞因子,有效改善哮喘小鼠气道炎症,表明DC可通过Notchl/Serrate 1信号通路影响调节性T细胞分化、逆转哮喘免疫耐受缺陷.     

肺干细胞研究进展

干细胞研究是现代医学领域研究热点之一.肺部疾病所导致的不同程度呼吸系统病理改变和功能受损,都伴随着肺组织的修复和重塑过程.对于肺部疾病的干细胞研究和应用尚有许多问题有待进一步的明确和探索.肺干细胞包括了肺组织自身的干细胞修复和肺外组织来源的干细胞修复.肺组织内的干细胞包括肺内上皮性干细胞、肺问充质干细胞、肺侧群细胞;其中肺内上皮性干细胞又包括了基底细胞、Clara细胞、Ⅱ型肺泡上皮细胞、"芽孢"样细胞.肺外组织来源的干细胞修复包括骨髓间充质干细胞和造血干细胞.干细胞治疗方法在临床上有巨大的应用前景.     

Syn及CD56在肺小细胞癌中的表达及意义

目的 探讨Syn和CD56在肺小细胞癌(SCLC)中的表达.方法 以20例肺小细胞癌标本作为实验组,以40例肺非小细胞癌组织作为对照组,应用免疫组织化学技术,分别检Syn和CD56在两组中的表达及在肿瘤不同临床病理特征之间的关系.结果 肺小细胞癌中Syn和CD56表达的阳性率明显高于对照组(P<0.01),Syn和CD56在肺小细胞癌中的表达具有正相关关系(P<0.01).结论 联合检测Syn和CD56在肺小细胞癌中的表达对区分两者有一定价值.     

诺帝对肺腺癌细胞系A549细胞增殖的影响

目的 探讨化学合成物诺帝对人肺腺癌细胞系A549细胞增殖的影响.方法 采用自行合成的化合物诺帝(终浓度为100 μmol/L)处理A549细胞,处理后12、24、48和72 h,用细胞培养、流式细胞仪检测、免疫组化及图像分析等方法检测诺帝对A549细胞的影响.结果 诺帝可使A549细胞增殖受抑制,对细胞周期抑制作用主要表现于G1→S期;诺帝处理后,A549细胞增殖细胞核抗原(PCNA)表达明显减弱.结论 诺帝对A549细胞的增殖有显著抑制作用,这种作用与其抑制PCNA有关.     

成人肺朗格汉斯细胞组织细胞增多症五例临床分析

目的 探讨成人肺朗格汉斯细胞组织细胞增多症(PLCH)患者的临床、影像、肺功能和组织病理特点.方法 回顾性分析2006年6月至2007年10月北京朝阳医院收治的5例PLCH患者的临床资料.结果 5例均为男性吸烟者,以肺部损害为主,其中2例以自发性气胸为首发症状,1例为肺脏终末期病变合并肺动脉高压.胸部高分辨率CT示大小不一的多发囊腔阴影,病变以双上肺为著,终末期病例囊腔影遍及全肺.5例均经外科肺活检获得组织病理学资料,显示囊腔样改变和朗格汉斯细胞聚集(免疫组织化学CD1a和S-100染色阳性).肺功能检查示V50占预计值%为53.6%～77.6%,V25占预计值%为38.5%～70.5%,V50和V25的降低与组织病理学所见小气道受累相符合.治疗以戒烟为主,疾病有自然缓解倾向.结论 PLCH是朗格汉斯细胞组织细胞增多症的一种特殊类型,主要发生于吸烟者,多呈良性经过.     

吸烟相关性肺朗格汉斯细胞组织细胞增生症病例报告和文献复习

目的 观察吸烟相关性肺朗格汉斯细胞组织细胞增生症(pulmonary Langerhans cell histiocytosis,PLCH)病理学、免疫组织化学特征及其影像学的动态变化.并复习有关PLCH的诊治进展.方法 1例经开胸肺组织活检、免疫组织化学和高分辨率CT(HRCT)证实的吸烟相关性PLCH患者,动态观察戒烟1年后肺HRCT影像学改变.结果 患者有吸烟史(吸烟指数200),确诊后经戒烟1年后肺HRCT显示结节性和囊性病变完全消失.结论 吸烟是本例PLCH患者发病主要原因,戒烟是治疗吸烟相关性PLCH的主要方法.     

Pulmonary Langerhans cell histiocytosis: emerging concepts in pathobiology,radiology, and clinical evolution of disease

Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon disorder of adult smokers associated with a significant morbidity. Arising from the aberrant accumulation of Langerhans and other immune cells, PLCH tends to cause a relatively isolated pulmonary involvement as compared to other forms of Langerhans cell (LC) and histiocytic disorders. Increased knowledge of cytokine triggers, dendritic cell trafficking, and clonality of LC populations in PLCH have resulted in an improved understanding of the pathobiology of PLCH. High-resolution CT (HRCT) of the chest has led to better appreciation of nodular and cystic radiographic abnormalities characteristic of the disease. Correlation of HRCT abnormalities with lung pathologic changes has led to an improved comprehension of clinical evolution of PLCH. Current clinical predictors for PLCH outcomes remain poor, although long-term follow-up and radiologic monitoring may help to define disease progression. This review discusses advances in PLCH emphasizing the etiopathologic bases of the disease and currently available radiologic modalities for monitoring disease progression.     

Pulmonary Langerhans Cell Histiocytosis and Diabetes Insipidus in Pregnant Women: Our Experience

Pulmonary Langerhans cell histiocytosis (PLCH) occurs predominantly in young adult smokers. Diabetes insipidus occurs in up to 15 % patients with PLCH. Information on PLCH in pregnancy is sparse, especially associated with diabetes insipidus. We report three patients with these conditions and describe the disease history and pregnancy outcomes.     

Rare lung diseases III: Pulmonary Langerhans�� cell histiocytosis

Pulmonary Langerhans’ cell histiocytosis (PLCH) is an unusual cystic lung disease that is also characterized by extrapulmonary manifestations. The current review discusses the presenting features and relevant diagnostic testing and treatment options for PLCH in the context of a clinical case. While the focus of the present article is adult PLCH and its pulmonary manifestations, it is important for clinicians to distinguish the adult and pediatric forms of the disease, as well as to be alert for possible extrapulmonary complications. A major theme of the current series of articles on rare lung diseases has been the translation of insights gained from fundamental research to the clinic. Accordingly, the understanding of dendritic cell biology in this disease has led to important advances in the care of patients with PLCH.     

Pulmonary Langerhans Cell Histiocytosis: Case Series and Literature Review

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease with insidious onset and nonspecific manifestations. The objective of this article was to characterize the clinical manifestations and features of PLCH by retrospectively analyzing clinical data of patients with PLCH in addition to simultaneous review of literature.A retrospective analysis was conducted on clinical data of patients with PLCH (n = 7), whose conditions were diagnosed by biopsy from pulmonary tissue (n = 6) or enlarged lymph nodes in the neck (n = 1) and confirmed by PLCH typical radiological features on computed tomography (CT) scan, between January 2001 and September 2012 at the Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. The review of published reports was made to further emphasize the clinical manifestation and radiological features of PLCH.Long history of cigarette smoking was found in 6 patients. Two patients had recurrent pneumothorax and the other 2 had pulmonary arterial hypertension (World Health Organization group 5 pulmonary hypertension), diagnosed through ultrasonic cardiogram. The nodular shadows were revealed by chest CT scan in 5 patients, cystic shadows in 5 patients, and reticular shadows in 2 patients, as major manifestations, respectively; most of the lesions were located in the middle or upper segments of the lung. The obvious shrank of lesion was found in 1 patient after completely quitting smoking.The pathogenesis of PLCH might be closely associated with smoking. The cystic or nodular lesion was the typical radiological features. Further prospective studies with large sample size are required to further validate the study results and understand the clinical characteristics of PLCH to avoid misdiagnosis.     

Pulmonary Langerhans' cell histiocytosis

Pulmonary Langerhans' cell histiocytosis (PLCH) is an uncommon but important cause of interstitial lung disease, and it occurs predominantly in adult cigarette smokers. PLCH belongs to the spectrum of Langerhans' cell histiocytosis (LCH), diseases characterized by uncontrolled proliferation and infiltration of various organs by Langerhans' cells. Other clinical entities within this spectrum of LCH are seen in adults and children and vary in severity from mild disease that requires no therapy to severe disseminated forms with extensive organ involvement and high mortality. Organ systems involved by LCH may include skin, bone, pituitary gland, lymph nodes, and lungs. Although LCH is approximately three times more common in children than adults, pulmonary involvement is much more common in adults with LCH, in whom it frequently occurs as the sole organ involved with disease. This article summarizes recent advances and current understanding of PLCH.     

Pneumothorax in pulmonary Langerhans cell histiocytosis

BACKGROUND: Pulmonary Langerhans cell histiocytosis (PLCH) is a smoking-related interstitial lung disease characterized by development of cystic changes that predispose to occurrence of pneumothorax. STUDY OBJECTIVES: To determine the frequency, recurrence rate, and optimal management of pneumothorax associated with PLCH. DESIGN: Retrospective study. SETTING: Tertiary care, referral medical center. PATIENTS: One hundred two adults >or= 18 years old with histologically confirmed PLCH seen at Mayo Clinic Rochester over a 23-year period from 1976 to 1998. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Sixteen of 102 patients (16%) with PLCH had pneumothorax; mean age at the time of diagnosis was 29.4 years (range, 18 to 52 years), and all had smoked cigarettes. There were 37 episodes of pneumothoraces (1 to 5 episodes per patient); 10 patients (63%) had more than one episode. Median age at diagnosis of PLCH was significantly younger in patients with pneumothorax when compared to those without pneumothorax (27 years vs 41.5 years, p < 0.001), but pulmonary function parameters and survival after diagnosis were not significantly different. Rate of recurrent pneumothorax was 58% to the ipsilateral side when the episode was managed by observation or chest tube without pleurodesis, and 0% after surgical management with pleurodesis. CONCLUSIONS: These data support the early use of surgical therapy with pleurodesis in managing patients with PLCH and spontaneous pneumothorax.     

The overlap between respiratory bronchiolitis and desquamative interstitial pneumonia in pulmonary Langerhans cell histiocytosis: high-resolution CT, histologic, and functional correlations

OBJECTIVES: To characterize the histologic, high-resolution CT (HRCT), and functional correlates of respiratory bronchiolitis (RB)/desquamative interstitial pneumonia (DIP)-like changes in biopsy specimens of adults with pulmonary Langerhans cell histiocytosis (PLCH). METHODS: We retrospectively identified 14 adult patients with histologically proven PLCH (all smokers) in whom both biopsy specimens and HRCT were available for review. The presence and extent of RB/DIP-like changes on lung biopsy specimens of patients with PLCH were correlated with total pack-years of smoking, lung function variables, and the presence of ground-glass attenuation on HRCT. RESULTS: Varying degrees of RB/DIP-like changes were identified in all biopsy specimens. The extent of involvement with RB/DIP-like changes correlated with the cumulative exposure to cigarettes smoked at the time of biopsy (r = 0.61, p = 0.03). Ground-glass attenuation was detected in three HRCTs, two of which had extensive RB/DIP-like changes (> or = 70% involvement) on histology, suggesting that substantial smoking-induced RB/DIP-like changes may be the cause of ground-glass attenuation on the HRCT of patients with PLCH. No correlation was found between the extent of RB/DIP-like changes and total lung capacity, FEV(1), or diffusion capacity of the lung for carbon monoxide. CONCLUSIONS: RB/DIP-like changes are exceedingly common in PLCH, may be sufficiently severe to cause the appearance of ground-glass attenuation on HRCT, and correlate with the cumulative exposure to cigarettes smoked. This study provides additional evidence that PLCH, RB, and DIP form a spectrum of interstitial patterns of lung injury to cigarette smoke.     

Pulmonary Langerhans' cell histiocytosis presenting with an endobronchial lesion

A 19-year-old man visited our hospital complaining of cough, sputum and low-grade fever. Chest radiograph and computed tomography findings suggested that he was suffering from pulmonary Langerhans' cell histiocytosis (PLCH). Bronchoscopy revealed a whitish elevated lesion at the bifurcation of the right upper lobe bronchus, and a specimen of this lesion showed the same pathological findings as pulmonary parenchymal lesions. Although there have been only a few reports of endobronchial LCH without pulmonary parenchymal lesions, this is, to our knowledge, the first case of PLCH with an endobronchial lesion, which was confirmed by bronchoscopy, and disappeared several months later.