Harris Bianca, Geyer Alexander I
Pulmonary Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Pulmonary Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA.
Clin Chest Med. 2017 Jun;38(2):317-331. doi: 10.1016/j.ccm.2016.12.008.
Pulmonary complications (PC) of hematologic malignancies and their treatments are common causes of morbidity and mortality. Early diagnosis is challenging due to host risk factors, clinical instability, and provider preference. Delayed diagnosis impairs targeted treatment and may contribute to poor outcomes. An integrated understanding of clinical risk and radiographic patterns informs a timely approach to diagnosis and treatment. There is little prospective evidence guiding optimal modality and timing of minimally invasive lung sampling; however, a low threshold for diagnostic bronchoscopy during the first 24 to 72 hours after presentation should be a guiding principle in high-risk patients.
血液系统恶性肿瘤的肺部并发症(PC)及其治疗是发病和死亡的常见原因。由于宿主危险因素、临床不稳定和医疗服务提供者的偏好,早期诊断具有挑战性。延迟诊断会影响靶向治疗,并可能导致不良后果。对临床风险和影像学模式的综合理解有助于及时进行诊断和治疗。目前几乎没有前瞻性证据指导微创肺活检的最佳方式和时机;然而,对于高危患者,在就诊后的最初24至72小时内进行诊断性支气管镜检查的低阈值应作为指导原则。