Fouret P, Touboul J L, Picard F, Mayaud C, Roland J
Ann Pathol. 1986;6(1):45-52.
In AIDS a variety of severe pulmonary disorders may occur. The authors report 110 cases of bronchoalveolar lavage (BAL) in 43 AIDS and 41 ARC. In AIDS P. carinii pneumonia is the major cause of respiratory illness. BAL alone is a safe and valuable tool for diagnosis of P. carinii pneumonia and others opportunistic infections. Moreover, pulmonary hemorrhage diagnosed by the finding of hemosiderin laden macrophages, is very suggestive of broncho-pulmonary Kaposi' sarcoma. Finally, BAL demonstrates a severe depletion of T4 lymphocytes and an increased number of T8 lymphocytes. The T8 lymphocytosis is observed whatever the pulmonary involvement (nonspecific alveolitis, opportunistic infections, Kaposi's sarcoma), and is also found in ARC, and lymphocytosis, open lung biopsy shows a lymphoid interstitial infiltration with respect of the alveolar septa, thus differing from the classical lymphoid interstitial pneumonia described by Carrington. The prognosis of lymphocytosis in ARC remains unknown.
在艾滋病患者中,可能会出现多种严重的肺部疾病。作者报告了43例艾滋病患者和41例艾滋病相关综合征患者的110次支气管肺泡灌洗(BAL)情况。在艾滋病患者中,卡氏肺孢子虫肺炎是呼吸系统疾病的主要病因。单纯支气管肺泡灌洗是诊断卡氏肺孢子虫肺炎和其他机会性感染的一种安全且有价值的工具。此外,通过发现含铁血黄素巨噬细胞诊断出的肺出血,强烈提示支气管肺卡波西肉瘤。最后,支气管肺泡灌洗显示T4淋巴细胞严重减少,T8淋巴细胞数量增加。无论肺部受累情况如何(非特异性肺泡炎、机会性感染、卡波西肉瘤),均可观察到T8淋巴细胞增多,在艾滋病相关综合征中也可发现,且伴有淋巴细胞增多,开胸肺活检显示肺泡间隔有淋巴样间质浸润,因此不同于卡林顿描述的经典淋巴样间质性肺炎。艾滋病相关综合征中淋巴细胞增多的预后尚不清楚。