淋巴细胞间质性肺炎7例临床、CT影像学及病理特征分析

［摘要］　目的　分析淋巴细胞间质性肺炎（LIP）的临床、CT影像学及病理特征。方法　回顾性分析7例经病理确诊的LIP患者的临床、影像资料，所有病例均进行胸部薄层CT检查。结果　7例LIP患者均为女性，4例表现为弥漫分布的斑片状磨玻璃影，其中3例伴有网格状影、小结节影；3例表现为局灶分布的斑片状磨玻璃影，其中1例局部夹杂小结节影。5例有多发薄壁含气肺囊肿，4例伴有纵隔淋巴结肿大。病理活检组织HE染色主要表现为肺间质内弥漫性淋巴细胞浸润，免疫组织化学染色主要提示CD3细胞和多克隆CD20细胞的增加。结论　LIP为罕见病，好发生于女性干燥综合征患者，当肺部高分辨率CT呈斑片状磨玻璃影并多发薄壁含气肺囊肿改变，病理表现为肺间质弥漫性淋巴细胞浸润时，高度提示LIP。

Analysis on the clinical CT imaging and pathological features of 7 cases of lymphocytic interstitial pneumonia

［Abstract］　Objective　To analyze the clinical, CT imaging and pathological features of 7 cases of lymphocytic interstitial pneumonia(LIP). Methods　The clinical and imaging data of 7 cases of LIP proved pathologically were retrospectively analyzed. All the cases underwent chest thin-section CT examination. Results　All the 7 LIP patients were female, among whom, 4 cases had the manifestation of diffuse patchy ground-glass opacities on their CT images. Among the 4 cases of diffuse patchy ground-glass opacities, 3 cases accompanied with grids and small nodules. Among the 7 LIP patients, 3 cases had the manifestation of focally distributed patchy ground-glass opacities. Among the 3 cases of focally distributed patchy ground-glass opacities, 1 case showed locally mixed small nodules. Among the 7 LIP patients, 5 cases had multiple thin-walled pulmonary cysts containing air, 4 cases accompanied with mediastinal lymph node enlargement. Hematoxylin and eosin(HE) staining of pathological biopsy tissues mainly showed diffuse lymphocyte infiltration in lung interstitium, and the immunohistochemical staining mainly indicated the increase of CD3 cells and polyclonal CD20 cells. Conclusion　LIP is a rare disease, which tends to occur in female patients with Sjgren′s syndrome. When the lungs show patchy ground-glass opacities and changes in multiple thin-walled pulmonary cysts containing air on chest high-resolution CT, and when the pathological manifestation is diffuse lymphocyte infiltration in the lung interstitium, LIP is highly suggested.