Tasaka Sadatomo, Tokuda Hitoshi, Sakai Fumikazu, Fujii Takeshi, Tateda Kazuhiro, Johkoh Takeshi, Ohmagari Norio, Ohta Hiromitsu, Araoka Hideki, Kikuchi Yoshimi, Yasui Masahide, Inuzuka Kanako, Goto Hajime
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo.
Intern Med. 2010;49(4):273-81. doi: 10.2169/internalmedicine.49.2871. Epub 2010 Feb 15.
The clinical features of pneumocystis pneumonia (PCP) differ according to the predisposing factors responsible for immunosuppression. Although PCP in patients with acquired immunodeficiency syndrome (AIDS) has been extensively described, its characteristics in non-AIDS patients, such as those with malignancies, are not thoroughly documented.
To characterize and compare the clinical and imaging features of PCP in patients with malignancies with those in AIDS patients.
A multi-center retrospective study.
We evaluated the clinical and radiological features of PCP in 21 patients with malignancies and in 17 with AIDS. Clinical presentation, serum markers, oxygenation, CT findings, and outcome were examined.
The patients with malignancies showed shorter durations of symptoms before PCP was diagnosed. The levels of serum markers and the oxygenation index did not differ. CT showed diffuse or widespread ground-glass opacity (GGO) in all of the patients evaluated. None of the AIDS patients demonstrated consolidation, whereas half of the patients with malignancy showed consolidation along with GGO. The extent of GGO scored on CT images was significantly greater in the AIDS patients. No correlation was observed between the CT findings and other clinical parameters. All of the AIDS patients recovered from PCP, whereas six patients with malignancies died within a month after the onset of PCP.
The characteristics of the CT images differed between the patient groups with different underlying disorders, although it remains to be determined whether CT findings are associated with other clinical features or are predictive of the outcome of PCP.
肺孢子菌肺炎（PCP）的临床特征因免疫抑制的诱发因素而异。虽然获得性免疫缺陷综合征（AIDS）患者的PCP已被广泛描述，但其在非AIDS患者（如恶性肿瘤患者）中的特征尚未得到充分记录。
描述并比较恶性肿瘤患者与AIDS患者PCP的临床和影像学特征。
一项多中心回顾性研究。
我们评估了21例恶性肿瘤患者和17例AIDS患者PCP的临床和放射学特征。检查了临床表现、血清标志物、氧合情况、CT表现及预后。
恶性肿瘤患者在PCP诊断前症状持续时间较短。血清标志物水平和氧合指数无差异。CT显示所有评估患者均有弥漫性或广泛性磨玻璃影（GGO）。所有AIDS患者均无实变，而一半的恶性肿瘤患者除GGO外还伴有实变。AIDS患者CT图像上GGO的范围评分显著更高。CT表现与其他临床参数之间未观察到相关性。所有AIDS患者的PCP均康复，而6例恶性肿瘤患者在PCP发病后1个月内死亡。
不同基础疾病患者组的CT图像特征不同，尽管CT表现是否与其他临床特征相关或能否预测PCP的预后仍有待确定。
