[Desquamative interstitial pneumonia: report of one case and review of literature].

Objective: To analyze the clinical features, diagnosis, and treatment of desquamative interstitial pneumonia(DIP). Methods: The clinical manifestation, radiology, and pathology were analyzed in one patient with DIP in Beijing Hospital following review of the literatures. Results: The patient was a 55-year-old male presented with cough, shortness of breath and hypoxemia.Previous history of smoking and exposure to a variety of metals. A CT scan of the chest revealed diffuse ground-glass densities. A diagnosis of desquamative interstitial pneumonia (DIP) was confirmed by a thoracoscopic open lung biopsy. After treatment with hormone, the condition improved.A total of 66 cases were included in this study, the smoking groupof 20 cases, non-smokers of 46 cases.The smoking group was older than the non-smoking group [(47.5±12.1)years vs (26.1±22.5) years]; the present of chest pain, shortness of breath(4/20 vs 0/46; 8/20 vs 3/46) was higher in smoking group than in non-smoking group, and ground glass opacity in the chest image(15/20 vs 20/46) was also higher in smoking group than in non-smoking group.Pulmonary function showed more diffuse dysfunction(12/14 vs 6/13) in smoking group than in non-smoking group. Conclusions: As a rare disorder, DIP is associated with current or former cigarette smoking and many other risk factors. The clinical presents of non-smoker is atypical.DIP is curable to glucocorticoid and has a good prognosis.There is a possible of recurrence.目的： 总结分析脱屑性间质性肺炎(desquamative interstitial pneumonia，DIP)患者的临床特点、诊治及预后，提高临床诊治水平。 方法： 报道北京医院收治的1例经病理诊断的DIP患者，回顾性分析国内外文献。以"desquamative interstitial pneumonia"为检索词，在PubMed数据库检索，检索时间截止至2015年12月，共检索到DIP相关英文文献共110篇，报道国外病例290例。以"脱屑性间质性肺炎"为检索词，分别在万方数据库和中国同方期刊数据库检索，检索时间截止至2015年12月，分别检索到相关中文文献57和20篇，报道患者38和60例。经阅读除外资料不详者及无病理诊断结果的文献，最终筛选获得65例，联合本例，针对66例进行文献复习。其中男44例(69.7%)，女22例(33.3%)，年龄0～67岁，平均年龄(33±22)岁，中位年龄34.5岁。比较吸烟相关性及非吸烟相关性DIP患者的临床表现差异。 结果： 患者男，55岁，表现为咳嗽、活动后气短，低氧血症。既往大量吸烟史及多种金属接触史。胸部CT示双肺磨玻璃影，行胸腔镜辅助下右肺上叶和中叶病变局部切除术，术后病理诊断脱屑性间质性肺炎。给予糖皮质激素治疗后好转。吸烟组20例，非吸烟者46例。吸烟组平均年龄(47.5±12.1)岁，与非吸烟组相比较高[(26.1±22.5)岁]；吸烟组患者出现胸痛、气短症状(4/20、8/20)多于非吸烟组患者(0/46、3/46)，胸部影像学表现以磨玻璃影为主(15/20)，肺功能表现为弥散功能障碍(12/14)。 结论： 脱屑性间质性肺炎是一种少见病，除吸烟外与多种危险因素相关。非吸烟导致DIP患者表现不典型。治疗对糖皮质激素敏感，预后良好，有复发可能。.