<原著>びまん性肺疾患における気管支肺胞洗滌液細胞成分に関する検討

Abstract

Cellular components of bronchoalveolar lavage fluid (BALF) recovered by fiberoptic bronchosopy were examined in 82 patients with diffuse interstitial lung diseases sarcoidosis (Sar), chronic berylliosis (Be), hypersensitivity pneumonitis (HP), idiopathic interstitial pneumonitis (IIP), interstitial pneumonitis associated with collagen vascular disease (CVD), gold therapy induced pneumonitis (Au), silicosis (Si), histiocytosis X (HX), and pulmonary infiltration with eosinophilia (PIE), and in 10 patients with chronic obstructive pulmonary diseas (COPD) and 17 control subjects. Cells recovered in BALF (10^5/ml) were greater than those for the control group in certain diffuse interstitial lung diseases : Sar, HP, HX, PIE. Changes in cellular composition were also observed in diffuse interstitial lung diseases. They are categorized into four groups, 1) those with an increase in lymphocyte percentage : Sar, Be, HP. 2) those with an increase in lymphocyte percentage and in some cases associated with increased percentage of neutrophils and eosinophils : Au. 3) those with an increase in neutrophil and eosinophil percentages, and in some cases associated with increased percentage of lymphocytes : IIP, CVD, Si. 4) those with an increase in eosinophil percentages : HX, PIE. Increases in cells recovered from BALF and changes in cellular composition may reflect ongoing local immuno-pathological processes in diffuse interstitial lung diseases. Relationships of these findings in cellular components of BALF to evaluation of disease activity, prognosis, and approach to immuno-pathology of diffuse interstitial lung diseases should be further investigated.