Pathology of pulmonary vasculitis.

摘要: There are three major vasculitis syndromes that affect the lung: Wegener's granulomatosis (WG), Churg-Strauss syndrome (CSS), and microscopic polyangiitis (MPA). The pathology of pulmonary is complicated because it requires correlation with clinical, laboratory, radiological features; there overlap in some histological features among syndromes; biopsies early course disease or after therapy may show atypical incomplete differential diagnosis complex includes infection should not be treated corticosteriods immunosupressive agents; few pathologists have much experience these cases. Major necrosis, granulomatous inflammation, characterize WG. inflammatory consolidation consists a mixture neutrophils, lymphocytes, plasma cells, macrophages, giant eosinophils. Necrosis take form neutrophil microabscesses geographic necrosis. Granulomas several forms, including scattered loose clusters palisading histiocytes cells lining border necrosis microabscesses, microgranulomas. Sarcoidal granulomas very rare. CSS eosinophilic pneumonia, allergic granulomas, vasculitis. Asthmatic bronchitis also present. Biopsies from patients rare this usually diagnosed clinically. Microscopic demonstrates neutrophilic capillaritis diffuse alveolar hemorrhage.