侵袭性肺曲霉病1例并文献复习

目的提高对侵袭性肺曲霉病的临床、胸部影像学、病原学和病理改变的认识。方法对1例经病理证实的侵袭性肺曲霉病患者的职业、临床表现、胸部X线、CT、气管镜和病理资料并结合文献进行回顾性分析。结果侵袭性肺曲霉病的临床表现缺乏特异性，典型的影像学检查显示胸膜下单发或多发结节状或斑片状阴影，并呈动态变化。GM试验用于诊断侵袭性肺曲霉病具快速灵敏的特点；侵袭性肺曲霉病的病理可见由大小规范，呈两分叉（Y形）的分隔菌丝引起的特征性的血管侵害，也可以表现为局限性肉芽肿或广泛化脓性肺炎。结论侵袭性肺曲霉病的临床表现和影像学改变非常复杂，在诊断中需要综合患者的各种临床资料（包括临床症状、放射学、血清学检查和病理）。

Invasive pulmonary aspergillosis:one ease report and literature review

Objective To highlight the clinical characteristics, imaging of chest, etiology and pathology of invasive pulmonary as- pergillosis. Methods The clinical, radiological and pathological data of a patient with invasive pulmonary aspergillosis confirmed by pa- thology were presented and the relevant literatures were reviewed. Results Patients with invasive pulmonary aspergillosis usually had no specific clinical syndrome. On chest radiography and CT scans, it presented single or multiple nodular or flake shadow, and the imagings were changing constantly. GM test was quick and sensitive in character for the diagnosis. The main pathological findings included the norreal size, the characteristic violations Of vascular induced by two bifurcation （Y shape） of myceliums. It also showed limited granuloma or extensive suppurative pneumonia. Conclusions The clinical syndrome and radiological of invasive pulmonary aspergillosis are very com- plex. Its diagnosis requires the information of all relevant clinical data of the patients, including syndrome, radiological serumal test and pathological data.