مقاربة آفات الرئة البارانشيمية المنتشرة في مشفى الأسد الجامعي باللاذقية ((أهمية التصوير الطبقي المحوسب عالي التمايز))
Abstract
اشتملت الدراسة على (43) مريضاً (16 ذكراً و 27 أنثى)، تراوحت أعمارهم بين 29-80 سنة، وكان (35) مريضاً منهم (81.39%) قد تجاوز عمره 40 سنة.كان تليف الرئة مجهول السبب والداء الرثياني السببان الأكثر شيوعاً لآفات الرئة البارانشيمية المنتشرة (DPLD), في دراستنا.أجري التصوير الطبقي المحوسب عالي التمايز (HRCT) لـِ (43) مريضاً (100%)، حيث شوهدت ظلال شبكية عقيدية لدى (15) مريضاً (34.88%) وظلال شبكية لدى (14) مريضاً (32.55%), ومظهر الزجاج الخشن لدى (10) مرضى (23.25%) ومظهر قرص العسل لدى (3) مرضى (6.97%).تم إجراء تنظير قصبات مع الغسالة القصبية السنخية أو الخزعة القصبية لـِ (7) مرضى (16.27%) بهدف نفي أمراض أخرى مشابهة لآفات الرئة البارانشيمية المنتشرة.
تم اللجوء إلى خزعة الرئة لوضع التشخيص لدى (4) مرضى (9.30%), وكان تشخيصهم: حالتي ذات رئة متعضية خفية المنشأ وحالة ساركوئيد وحالة فرفرية هنوخ – شنلاين.
43 patients (16 males, 27 females), aged 29-80 years, were included in the study. Of the (43) patients, 35 (81.39%) were over 40 years of age.
Idiopathic pulmonary fibrosis and rheumatoid arthritis were the most common causes of DPLD in our study. HRCT was performed on 43 patients (100%), which showed reticulonodular shadows in 15 patients (34.88%), reticular shadows in 14 patients (32.55%), ground – glass appearance in 10 patients (23.25%) and honeycombing in 3 patients (6.97%). Bronchoscopy with bronchoalveolar lavage or endobronchial biopsy was performed in 7 patients (16.27%) to exclude other diagnoses. Lung biopsy was used to make diagnosis in 4 patients (9.30%), which revealed cryptogenic organizing pneumonia in 2 patients, sarcoidosis in one patient and Henoch-Schoenlein purpura in one patient.
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