Dinkel E, Meyer E, Mundinger A, Helwig A, Blum U, Würtemberger G
Abteilung Röntgendiagnostik, Radiologische Universitätsklinik Freiburg.
Radiologe. 1990 Dec;30(12):591-7.
The radiological findings in pulmonary lymphangitic carcinomatosis and in leukemic pulmonary infiltrates mirror the tumor-dependent monomorphic interstitial pathology of lung parenchyma. It is a proven fact that pulmonary lymphangitic carcinomatosis is caused by hematogenous tumor embolization to the lungs; pathogenesis by contiguous lymphangitic spread is the exception. High-resolution CT performed as a supplement to the radiological work-up improves the sensitivity for pulmonary infiltrates in general and thus makes the differential diagnosis decided easier. Radiological criteria cannot discriminate the different forms of leukemia. Plain chest X-ray allows the diagnosis of pulmonary involvement in leukemia due to tumorous infiltrates and of tumor- or therapy-induced complications. It is essential that the radiological findings be interpreted with reference to the stage of tumor disease and the clinical parameters to make the radiological differential diagnosis of opportunistic infections more reliable.
肺淋巴管癌病和白血病肺部浸润的影像学表现反映了肺实质中肿瘤相关的单形性间质病理改变。肺淋巴管癌病由血行性肿瘤栓子栓塞至肺部引起,这是一个已被证实的事实;通过连续淋巴管播散的发病机制则为例外情况。作为影像学检查的补充而进行的高分辨率CT总体上提高了对肺部浸润的敏感性,从而使鉴别诊断更容易确定。影像学标准无法区分白血病的不同类型。胸部X线平片可诊断因肿瘤浸润导致的白血病肺部受累情况以及肿瘤或治疗引起的并发症。至关重要的是,必须结合肿瘤疾病的分期和临床参数来解读影像学表现,以使机会性感染的影像学鉴别诊断更可靠。