Oldham S A, Castillo M, Jacobson F L, Mones J M, Saldana M J
Department of Diagnostic Radiology, University of Miami School of Medicine, Jackson Memorial Medical Center, FL 33136.
Radiology. 1989 Jan;170(1 Pt 1):83-7. doi: 10.1148/radiology.170.1.2909125.
The authors reviewed chest radiographs of 16 patients with biopsy-proved lymphocytic interstitial pneumonia (LIP) who also had acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC). Radiographs revealed fine reticular or reticulonodular infiltrates in the pulmonary interstitium in five patients, coarse reticulonodular infiltrates in two, and reticular or reticulonodular opacities with superimposed patchy alveolar infiltrates in nine. Pathologic examination of biopsy specimens revealed lymphocytes, plasma cells, and reticulum cells aggregated about the small arteries and compressing the distal airways. Throughout the course of AIDS or ARC, the radiographic findings of LIP remained stable in 12 of 16 patients. AIDS/ARC-related LIP appears to be a benign reaction of bronchial-associated lymphatic tissue to the human immunodeficiency virus (HIV). However, this indolent process cannot be correctly diagnosed based on radiographic findings alone; the use of lung biopsy is required to differentiate LIP from other infections. The authors suggest that patients with these radiographic findings, HIV seropositivity, but no other signs of opportunistic infection or neoplasia should be classified as having AIDS.
作者回顾了16例经活检证实为淋巴细胞间质性肺炎（LIP）且患有获得性免疫缺陷综合征（AIDS）或AIDS相关综合征（ARC）患者的胸部X光片。X光片显示，5例患者肺部间质有细网状或网状结节状浸润，2例有粗网状结节状浸润，9例有网状或网状结节状阴影并伴有斑片状肺泡浸润。活检标本的病理检查显示，淋巴细胞、浆细胞和网状细胞聚集在小动脉周围并压迫远端气道。在整个AIDS或ARC病程中，16例患者中有12例LIP的X光表现保持稳定。AIDS/ARC相关的LIP似乎是支气管相关淋巴组织对人类免疫缺陷病毒（HIV）的一种良性反应。然而，仅凭X光表现无法正确诊断这种进展缓慢的疾病；需要进行肺活检以将LIP与其他感染区分开来。作者建议，有这些X光表现、HIV血清学阳性但无其他机会性感染或肿瘤迹象的患者应归类为患有AIDS。
