| ObjectiveTo analyze the pathological features and clinical follow-up of lung biopsy for benign disease of lung.MethodsPatients with benign pulmonary disease were collected from Qilu Hospital of Shandong University between January 2017 and March 2019.The main pathological findings of benign pulmonary disease were summarized,and the final follow-up diagnosis results of non-surgical cases and all granulomatous diseases were recorded.Analyze the differences between pathological diagnosis and final clinical diagnosis.Results1.A total of 245 cases were included in the study,of which 99 cases(40.41%)were from CT-guided lung puncture biopsy specimens,59 cases(24.08%)were from bronchoscopy biopsy specimens,and 87 cases(35.51%)were from partial lung resection biopsy specimens.The common pathological manifestations of benign pulmonary diseases included 123 cases of general acute and chronic inflammation(50.2%),64 cases of granulomatous inflammation(26.1%),24 cases of organizing pneumonia(9.8%),and the other 34 cases(13.9%%)benign pulmonary diseases including 7 cases of hamartoma,8 cases of inflammatory pseudotumor,6 cases of pulmonary isolation,3 cases of atypical hyperplasia,3 cases of amyloidosis.There were 3 solitary fibrous tumors and 4 sclerosing hemangioma.2.Compared with general acute and chronic inflammation,more women than men had granulomatous inflammation(p<0.05).There was no significant difference in clinical symptoms and imaging features between acute and chronic inflammation and granulomatous inflammation(p>0.05).The incidence of mediastinal lymphadenopathy was lower in patients with the other benign pathological changes than in patients with organizing pneumonia(p<0.05),but there was no significant difference in other clinical features(p>0.05).3.Among 123 patients with general acute or chronic inflammation,26 patients underwent partial pneumonectomy and 5 patients underwent radiofrequency ablation.The remaining 92 patients with general acute or chronic inflammation were followed up.The number of patients who could be followed up was 79,and 50 cases(63.3%)were able to obtain a definite diagnosis,including 38 cases of infectious diseases,including 20 cases of bacterial pneumonia,3 cases of tuberculosis,10 cases of Aspergillus,1 case of Cryptococcus,1 case of Mucor and 3 cases of unspecified fungi.12 cases of non-infectious diseases,including 5 cases of lung cancer,2 cases of interstitial pneumonia,2 cases of connective tissue disease,2 cases of organized pneumonia,and 1 case of lung cyst.Of the 29 patients who were not identified,27 were stable after follow-up,and 2 died of other diseases.4.The 64 patients with granulomatous inflammation were followed up,and 46 cases(76.67%)were confirmed,including 31 cases of tuberculosis,9 cases of sarcoidosis,2 cases of fungus,2 cases of bacterial pneumonia,1 case of mixed infection of tuberculosis and fungus,and 1 case of non-tuberculosis mycobacterium infection.Of the 14 patients with granulomatous inflammation that were not confirmed,6 cases underwent surgical resection.Among the remaining 8 cases,3 showed no change in CT review compared with before,2 cases spontaneously relieved after CT review without medication,and 3 cases did not undergo review due to no clinical symptoms.5.Of the 24 patients with pathological manifestations of organizing pneumonia,21 were FOP,and 14 were surgically resected,including 2 cases of SOP,associated with infection and tumor respectively,and the other 12 cases were COP.Of the 10 cases from CT-guided lung puncture biopsy specimens,4 cases were COP and 3 cases were SOP associated with infection.ConclusionThe main pathological manifestations of lung biopsy for benign lung diseases are general acute and chronic inflammation,followed by granulomatous inflammation and organized pneumonia.Patients with pathological manifestations above need further clinical follow-up to determine the etiology.Most of the pathological manifestations without clear etiology have good prognosis after clinical treatment or untreatment. |
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