Golde D W, Drew W L, Klein H Z, Finley T N, Cline M J
Br Med J. 1975 Apr 26;2(5964):166-8. doi: 10.1136/bmj.2.5964.166.
Through gleeding into the lung parenchyma is responsible for morbidity and mortality in patients with leukaemia pulmonary haemorrhage is seldom diagnosed during life. We diagnosed occult pulmonary haemorrhage in five leukaemic patients with unexplained infiltrates on chest roetgenograms by examining alveolar macrophages retrieved by bronchopulmonary lavage. Macrophage haemosiderin content was greatly increased in the patients with pulmonary haemorrhage as compared to normal and thrombocytopenic control subjects. Haemoglobin and intact erythrocytes in alveolar macrophages were taken as evidence of recent haemorrhage. Intrapulmonary bleeding may occur often in patients with leukaemia, and bronchopulmonary lavage offers a safe approach to diagnosis and allows for concomitant identification of pulmonary infection.
白血病患者肺部实质内出血是发病和死亡的原因，白血病性肺出血在生前很少被诊断出来。我们通过检查经支气管肺灌洗回收的肺泡巨噬细胞，诊断出5例白血病患者胸片上有无法解释的浸润影，存在隐匿性肺出血。与正常和血小板减少的对照受试者相比，肺出血患者巨噬细胞含铁血黄素含量大大增加。肺泡巨噬细胞内的血红蛋白和完整红细胞被视为近期出血的证据。白血病患者常发生肺内出血，支气管肺灌洗为诊断提供了一种安全的方法，并能同时识别肺部感染。
