Gurney J W, Bates F T
Department of Radiology, University of Nebraska Medical Center, Omaha 68105.
Radiology. 1989 Oct;173(1):27-31. doi: 10.1148/radiology.173.1.2789412.
A rare pulmonary manifestation of the acquired immunodeficiency syndrome or intravenous (IV) drug abuse is upper lobe cystic disease--pneumatoceles in Pneumocystis carinii pneumonia (PCP) and bullous emphysema in IV drug abuse. Because these disorders overlap, the radiographic findings in 56 patients were compared. During a 12-month period, 16 patients less than 40 years of age were found to have bullous emphysema; the 10 who were IV drug abusers constituted group 1. In the same time period, 40 patients with PCP were encountered; the eight (20%) who had or developed pneumatoceles constituted group 2. In both groups, the conventional radiographic manifestations of upper lobe cystic disease were similar. Eight patients underwent computed tomography of the chest. In five patients with bullous disease, the distribution of the bullous lesions was peripheral, with sparing of the central portions of the lungs. In contrast, PCP pneumatoceles in three patients were dispersed throughout the lung parenchyma.
获得性免疫缺陷综合征或静脉注射毒品滥用的一种罕见肺部表现是上叶囊性疾病——卡氏肺孢子虫肺炎（PCP）中的肺气囊和静脉注射毒品滥用中的大疱性肺气肿。由于这些疾病存在重叠，对56例患者的影像学表现进行了比较。在12个月期间，发现16例40岁以下患者患有大疱性肺气肿；其中10例静脉注射毒品滥用者组成第1组。在同一时期，遇到40例PCP患者；其中8例（20%）出现或发展为肺气囊，组成第2组。两组中上叶囊性疾病的传统影像学表现相似。8例患者接受了胸部计算机断层扫描。在5例患有大疱性疾病的患者中，大疱性病变分布于外周，肺中央部分未受累。相比之下，3例PCP肺气囊患者的病变分散于整个肺实质。
