Páldy L, Ivády G
Natl Cancer Inst Monogr. 1976 Oct;43:99-119.
Sixt-two series of radiographs were analyzed. Interstitial plasma cell pneumonia (IPCP) was divided into six radiographic stages. A schematic description of these stages is given. The correlation between this scheme and the actual radiographs is illustrated with a series of nine antero-posterior and lateral radiographs from one infant. The patterns of the individual stages of the disease are then discussed with the aid of pulmonary radiographs of 12 infants and one 12-month-old child with dysgammaglobulinemia. From a prospective and retrospective analysis of these radiographs, we could delineate the development of the disease from the earliest radiologically recognizable lesions to resolution. The long incubation time of IPCP was established by a retograde analysis of several series of radiographs of proved cases; the time interval was determined between the earliest recognizable change and the full-blown picture of stage V, in which the interstitial infiltrative process may be accompained by various degrees of emphysema, edema (used synoymously with alveolar filling process), pneumothorax, and madiastinal emphysema. This scheme has proved its value during 20 years of radiographic diagnostic pactice with 30-35 annual consultations concerning IPCP; IT CORRELATES WELL WITH THE CLINICAL SYMPTOMATOLOGY AND THE RESPONSE TO THERAPY. Points of differential diagnostic importance concerning other interstitial infiltrative processes of the lungs are discussed for every stage of the disease.
分析了62组X光片。间质性浆细胞肺炎(IPCP)被分为六个X光分期。给出了这些分期的示意图。通过一名婴儿的一系列九张前后位和侧位X光片说明了该分期方案与实际X光片之间的相关性。然后借助12名婴儿和一名患有免疫球蛋白异常血症的12个月大儿童的肺部X光片讨论了疾病各个阶段的模式。通过对这些X光片的前瞻性和回顾性分析,我们能够描绘出疾病从最早的可放射学识别的病变到消散的发展过程。通过对几例确诊病例的一系列X光片进行逆行分析确定了IPCP的长潜伏期;确定了最早可识别变化与V期典型表现之间的时间间隔,在V期,间质性浸润过程可能伴有不同程度的肺气肿、水肿(与肺泡填充过程同义)、气胸和纵隔气肿。在20年的X光诊断实践中,每年就IPCP进行30 - 35次会诊,该方案已证明了其价值;它与临床症状和对治疗的反应密切相关。针对疾病的每个阶段讨论了与肺部其他间质性浸润过程有关的鉴别诊断要点。