Nakagomi Takayuki, Kitada Osamu, Nakamura Hitoshi, Miyata Shigeru, Aragane Kazumi, Kodama Taku, Kuribayashi Kouzou, Jin Shoko, Takenaka Noriko, Nagasawa Namiko, Sugita Minoru
Department of Internal Medicine, Division of Respiratory Disease, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 Oct;40(10):812-6.
A 60-year-old man was admitted to our hospital complaining of progressive dyspnea. On admission, he had marked hypoxemia, and his chest radiography and computed tomography (CT) showed ground glass opacities and multiple emphysematous changes in both lung fields. On examining the patient's bronchoalveolar lavage fluid (BALF). Pneumocystis carinii pneumonia (PCP) was diagnosed. A serological test for human immunodeficiency virus (HIV)-1, 2 was positive, and acquired immunodeficiency syndrome (AIDS) was diagnosed. Since the chest CT performed a month before the patient's admission to our hospital revealed ground glass opacities in both lung fields we thought that he had already developed PCP at that time. In comparison with his previous CT, the chest CT on admission showed progressive ground glass opacities and emphysematous changes. Although PCP is known to display various findings on chest radiography and CT, emphysematous changes are rarely reported in Japan. In this case we were able to confirm these changes and observe its progression using chest CT.
一名60岁男性因进行性呼吸困难入院。入院时，他有明显的低氧血症，胸部X线和计算机断层扫描（CT）显示双肺野有磨玻璃影和多处肺气肿改变。检查患者的支气管肺泡灌洗液（BALF）后，诊断为卡氏肺孢子虫肺炎（PCP）。人类免疫缺陷病毒（HIV）-1、2的血清学检测呈阳性，诊断为获得性免疫缺陷综合征（AIDS）。由于患者入院前一个月进行的胸部CT显示双肺野有磨玻璃影，我们认为他当时已经患上了PCP。与之前的CT相比，入院时的胸部CT显示磨玻璃影和肺气肿改变有所进展。虽然已知PCP在胸部X线和CT上有各种表现，但在日本很少报道有肺气肿改变。在这个病例中，我们能够通过胸部CT确认这些改变并观察其进展情况。
