A 54-year-old man was admitted to respiratory department with chief complaints of recurrent cough and dyspnea. Chest imaging showed multiple patchy shadows and interstitial changes. Evidence of infectious diseases was not definite, and antibiotic treatments were not effective. In the meantime, myelodysplasia syndrome was diagnosed with pancytopenia. The pathologic findings of transbronchoscopic lung biopsyshowed chronic inflammatory interstitial changes, suggesting a clinical diagnosis of organizing pneumonia. After glucocorticoids treatment, his condition aggravated. The second percutaneous lung biopsy showed the infiltration of a large number of neutrophils. Therefore, the final diagnosis of myelodysplasia syndrome with Sweet syndrome was made. Then glucocorticoids and supportive treatment were given This case may improve physicians' understanding of myelodysplasia syndrome complicated with Sweet syndrome.
患者男，54岁。因咳嗽、呼吸困难、肺部阴影就诊于上海长海医院呼吸与危重症医学科。患者反复出现咳嗽和呼吸困难，胸部影像学提示两肺多发斑片状阴影并间质性改变，多次检查病原学阴性，多种抗菌药物治疗无效。患者合并血象三系异常，骨髓穿刺活检提示骨髓增生异常综合征。第一次肺组织活检，病理示慢性间质性炎症，考虑机化性肺炎。治疗期间病情急性加重，行第二次肺组织活检，病理可见大量中性粒细胞浸润。该患者最后诊断为骨髓增生异常综合征并发Sweet综合征。予糖皮质激素及对症支持治疗。本例旨在提高临床医生对骨髓增生异常综合征合并Sweet综合征的认识。.
Keywords: Lung diseases, interstitial; Myelodysplastic syndrome; Sweet's syndrome.