石棉沉积症伴肺间质纤维化1例误诊原因分析

目的 阐明石棉沉积性肺间质纤维化的临床病理特征，提高对其临床及病理表现的认识，避免漏诊和误诊。方法 报道1例石棉沉积性肺间质纤维化的临床和病理改变，并结合文献对该疾病的临床表现及病理学特征进行讨论。结果 组织学表现为胸膜、肺泡间隔和支气管血管周围呈慢性炎症及纤维化，病变不连续，与相对正常的肺组织相间隔。肺间质中可见散在分布的串珠样石棉小体，铁染色（＋），呈蓝黑色。结论 肺石棉沉积症的病理改变主要为肺间质纤维化，病变类似普通型间质性肺炎（UIP），其诊断和鉴别诊断主要依据在肺间质纤维化背景中找到石棉小体，可使用铁染色加以证实。

Asbestosis with diffuse interstitial fibrosis of lung: a clinicopahtologic study

Objective To investigate the chnicopathologic features of asbestosis in order to improve the recognition of clinical and pathological manifestations. Methods A case of asbestosis was studied with conventional histopathological and histoehemical stains, and its clinical and pathological findings were discussed with review of the literature. Results The lung showed a peripheral acinar pattern of intestitial fibrosis and inflammation alternating with relatively normal alveoli. The inflammation and fibrosis predominantly involved the pleura, intedobular septa and larger bronchovascular structures. The rodlike, beaded asbestos bodies, which were blue-black with iron staining, were seen in fibrotic tissue. Conclusion The interstitial process of asbestosis is typically pathchy, similar to the pattern of usual interstitial pneumonitis, Asbestosis can be diagnosed when intersifial fibrosis is associated with intrapulmonary asbestos bodies, and the iron staining may be helpful.