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亮白色可极化晶体,但都在血管内呈弥漫和集中分布。这是一个长期静脉内用药的病人的肺。仅有大约1%的这种病人出现明显的肺纤维化。晶体代表滑石,滑石用来稀释注射的药物。

Bright white collections of polarizable crystals are seen here, but are diffuse and centered around vascular spaces. This is the lung of a patient with a long history of intravenous drug use. Only about 1% of such persons get a significant degree of pulmonary fibrosis. The crystals represent talc that is used to to dilute the injected drug.

肺血管内的圆洞是脂肪栓子。脂肪栓塞最常发生于伴有长骨骨折的外伤,骨折脂肪细胞破裂释放脂肪滴进入血液循环中,脂肪滴进入肺毛细血管,逐渐产生类似于大鞍状血栓引起的肺动脉栓塞的后果。

The rounded holes that appear in the vascular spaces here in the lung are fat emboli. Fat embolization syndrome occurs most often following trauma with fracture of long bones that releases fat globules into the circulation which are trapped in pulmonary capillaries. Cumulatively, they have the same effect as a large saddle pulmonary embolus.

图示足月妊娠分娩罕见的并发症。可见肺动脉分支内的羊水栓子,有数层胎儿鳞屑。羊水栓塞可产生类似于大鞍状血栓引起的肺动脉栓塞的后果。

This is a rare finding that may complicate a term pregnancy at delivery. Seen here in a pulmonary artery branch is an amniotic fluid embolus that has layers of fetal squames. Amniotic fluid embolization can have the same outcome as a large saddle pulmonary embolus.

图示过敏性肺炎,当吸入有机粉尘后通过抗原-抗体复合物引起Ⅲ型超敏反应。病人脱离变应原所在环境时,呼吸困难、咳嗽、发热会减轻。没有明显的长期并发症。

This is an example of hypersensitivity pneumonitis that can occur when there is an inhaled organic dust that produces a localized for of type III hypersensitivity (Arthus) reaction from antigen-antibody complexes. The symptoms of dyspnea, coughing, and fever abate when the affected person leaves the environment where the offending antigen is located. There are no major long-term complications.

过敏性肺炎的一种类型农民肺,由于农民吸入耐热的放线菌,它由发霉的干草中繁殖生长。鸟尘(爱鸟病)和空调中的霉也引起类似的问题。田野中标准捆包,质量好,就很少发生种此病。

One form of hypersensitivity pneumonitis is known as farmer's lung because the farmer inhales thermophilic actinomycetes in moldy hay that set off the reaction. Bird dust (bird fancier's disease) and molds in air conditioners may produce similar problems. The bales in this field near Sterling are of good quality and less likely to produce this disease.

农民肺必须与silo filler's 病区别开来,是因毒气由发酵的青贮饲料向筒仓空气中释放引起的急性化学性肺炎(图示位于爱丁堡和格拉斯哥之间的农场)。

Farmer's lung must be distinguished from "silo filler's disease" which is an acute chemical pneumonitis due to toxic gases released from fermenting silage into the atmosphere inside the silo (an example of which is seen here on this farm between Edinburgh and Glasgow).

图示肺纤维化。一些限制性肺疾病的病因不明(如图),称为特发性肺纤维化。肺泡炎引起成纤维细胞增生和胶原沉积。

This is an example of pulmonary fibrosis. Some cases of restrictive lung disease have no known etiology--this is, they are known as idiopathic pulmonary fibrosis. The alveolitis that produces fibroblast proliferation and collagen deposition is progressive over time.

三色染色把肺纤维化病人的结缔组织中的胶原纤维染成蓝色。

A trichrome stain highlights the collagenous connective tissue of pulmonary fibrosis in blue.

肺间质纤维化的原因之一是结节病。除了增多肺纹理,胸片还可见明显的肺门淋巴结病(非干酪性肉芽肿性炎症)。

One cause for pulmonary intersitital fibrosis is sarcoidosis. In addition to increased interstitial markings, the chest radiograph may display prominent hilar lymphadenopathy (from non-caseating granulomatous inflammation) as shown here.

弥漫性肺泡损伤,病变的肺组织比较坚韧、有弹性。临床上表现为成*人呼吸窘迫综合征( ARDS)。

Here is an example of diffuse alveolar damage in which the lung is diffusely firm and rubbery. Clinically, this is known as adult respiratory distress syndrome (ARDS).


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