閉塞性肺炎を繰り返し,内視鏡で治癒過程を観察し得た気管支放線菌症の1例  [in Japanese] Endobronchial Actinomycosis  [in Japanese]

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Abstract

症例は63歳男性. 繰り返す肺炎の精査中に胸部 CT scan で右下葉に腫瘤状陰影を認め, 肺癌を疑い気管支鏡施行. 右下幹入口部を閉塞するように表面不整で一部壊死物質に覆われた腫瘤を認め, 確定診断の目的で気管支生検およびその末梢の肺生検を施行. 組織学的に気管支においては好中球を中心とした炎症細胞浸潤と放線菌の菌塊を認め, 末梢肺生検ではリンパ球を中心とした慢性炎症所見を認めたことより, 気管支放線菌症およびそれによる閉塞性肺炎と診断した. 治療として, ピペラシリンの点滴治療およびアモキシシリンの内服治療を行い, 内視鏡的に著明な改善を確認できた.

A 63-year-old man was admitted to our hospital with obstructive pneumonia. The chest X-ray film and computed tomogram showed an infiltrative shadow in the right lower lung field. Examination with a fiberoptic bronchoscope showed a mass in the right basal bronchus. These findings suggested the diagnosis of lung cancer with obstructive pneumonia. Histopathological examination of a specimen obtained by transbronchial biopsy revealed sulfur granules with infiltration of neutrophils, which led to the diagnosis of endobronchial actinomycosis. After three months of treatment with penicillin, the mass disappeared. Comparison of bronchoscopic findings before and after penicillin treatment clearly showed the efficacy of therapy.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 34(9), 989-992, 1996-09-25

    The Japanese Respiratory Society

References:  8

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008110991
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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