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間質性形質細胞性腦炎

Interstitial plasma cel pneumonia

중앙의학 1961년 1권 6호 p.671 ~ 677
김기홍,
소속 상세정보
김기홍 (  ) - 국립의료원 병리과

Abstract


Interstitial plasmacellular pneumonia due to pneumocystis carinii had not called attention of both clinicians and pathologists in Korea, until one case of the disease was identified by necropsy on May 1959 by the present author at National Medical Center in Seoul.
In the last several decades many cases of pneumocystis pneumonia have been reported mainlysin central Europe, but only a few in the United States, Canada, and South America, It is interesting to speculate as to whether the disease is spreading from Europe or probable failure to make proper diagnosis in the past.
Pneumocystis carinii, the etiologic micro-organism, found and named by Vanek and Jirovek in 1952 has been thought to be a protozoon, but some have believed the infection is due to fungus.
Clinically, pneumocystis pneumonia affects usually premature or debilitated infants, rarely older children and adults debilitated by malignant neoplasm or chronic infection, being manifested by dyspnea and cyanosis. Pathologically, it is characteried by (1) extensive infiltration of large mononuclear cells, plasma cells and lymphocytes in the widened alveolar septa of the lungs, (2) cuboidal metaplasia and hyperplasia of lining cells with more or less desquamation, (3) distended alveoli and alveolar ducts filled with peculiar eosinophilic spongy material containing the organism, and (4) almost complete lack of inflammatory cellular infiltration in the alveolar lumina. The pathologic pictures differ from those of ordinary virus pneumonia, especially being characterized by lack of bronchiolitis.
Why premature iufants aged 1 to 4 months are most susceptible is unknown. Probably low resistance plays a decisive role, but some suggests that agmmaglobulinemia or hypogammaglobulinemia has predisposing influence.
This case is believed to be compatible clinically and pathologically with the -above mentioned findings of pneumocystis pneumonia.

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