CAJ | 학술논문

目的探讨煤工尘肺肺引流淋巴结的病理特征及其对煤工尘肺早期诊断的意义.方法对12例煤矿工人的尸检资料采用HE染色、光学显微镜下观察,并结合职业史进行回顾性分析.结果 12例尸检病例中1例粉尘性反应患者的肺引流淋巴结多为煤尘沉着,纤维轻度增生,髓窦区小范围的尘性纤维化;1例煤矽肺Ⅰ期患者肺引流淋巴结主要表现为大范围的尘性纤维化及煤尘沉积;8例煤矽肺Ⅱ期患者主要表现为尘性纤维化和矽结节;1例煤矽肺Ⅲ期、1例矽肺Ⅲ期主要表现为矽结节及矽结节的融合、淋巴结相互粘连并形成大块状纤维化,后者矽结节的形成尤为突出.结论煤工尘肺的肺部病变越严重,肺引流区淋巴结的尘性病变亦越为严重.而单纯矽肺的肺引流淋巴结病变要早于和重于肺部病变.
목적 탐토매공진폐폐인류림파결적병리특정급기대매공진폐조기진단적의의.방법 대12례매광공인적시검자료채용HE염색、광학현미경하관찰,병결합직업사진행회고성분석.결과 12례시검병례중1례분진성반응환자적폐인류림파결다위매진침착,섬유경도증생,수두구소범위적진성섬유화;1례매석폐Ⅰ기환자폐인류림파결주요표현위대범위적진성섬유화급매진침적;8례매석폐Ⅱ기환자주요표현위진성섬유화화석결절;1례매석폐Ⅲ기、1례석폐Ⅲ기주요표현위석결절급석결절적융합、림파결상호점련병형성대괴상섬유화,후자석결절적형성우위돌출.결론 매공진폐적폐부병변월엄중,폐인류구림파결적진성병변역월위엄중.이단순석폐적폐인류림파결병변요조우화중우폐부병변.
Objective To investigate the pathological characteristics of draining pulmonary lymph nodes in coal workers' pneumoconiosis (CWP) and study their significance for the early diagnosis of CWP.Methods The autopsy materials of 12 coal workers were subjected to HE staining and observed under a light microscope,and a retrospective analysis was performed considering the occupational history.Results The age range of 12 cases was 46～71 years (mean,58 years),and the exposure time range was 3～32 years (mean,22.8 years).The draining pulmonary lymph nodes of 1 case with dust reaction mostly had coal dust deposition,mild pulmonary fibrosis,and local dust fibrosis in the medullary sinus; 1 case of stage Ⅰ anthracosilicosis mainly showed extensive dust fibrosis and coal dust deposition; 8 cases of stage Ⅱ anthracosilicosis mainly showed dust fibrosis and silicotic nodules; 1 case of stage Ⅲ anthracosilicosis and 1 case of stage Ⅲ silicosis mainly showed silicotic nodules' fusion with each other,and lymph nodes' adhesion and formation of massive fibrosis,and the formation of silicotic nodules was especially obvious in cases of stage Ⅲ silicosis.Conclusion The dust lesions of draining pulmonary lymph nodes become severer with higher severity of pulmonary lesions in cases of CWP.The cases of simple silicosis have earlier and severer lesions in draining pulmonary lymph nodes than in lung tissue.