Rollins S D, Colby T V
Department of Pathology, University of Utah Medical Center, Salt Lake City 84132.
Arch Pathol Lab Med. 1988 Jun;112(6):607-11.
Nine patients with chronic lymphocytic leukemia (CLL), with pulmonary involvement confirmed by biopsy, presented with progressive cough and/or shortness of breath and had interstitial infiltrates on chest radiographs. Biopsies showed a dense lymphocytic infiltrate that followed bronchovascular bundles. We considered CLL the predominant finding, and the cause of the patient's pulmonary disease, in eight cases; in one, a histologically nonspecific organizing pneumonia was the main lesion and CLL was an incidental finding. Culture results were available in six cases and were negative except in one case with presumed contaminants. A granulomatous reaction was present in five cases and was necrotizing in two, although culture results were negative. The only case with a recognizable organism had noninvasive fungal hyphae growing in many of the small airways. All of the patients' respiratory symptoms improved after chemotherapy and/or steroid therapy, and the chest radiographs also showed clearing.
9例经活检证实有肺部受累的慢性淋巴细胞白血病（CLL）患者，表现为进行性咳嗽和/或呼吸急促，胸部X线片显示有间质浸润。活检显示沿支气管血管束有密集的淋巴细胞浸润。8例患者中，我们认为CLL是主要发现及患者肺部疾病的病因；1例患者主要病变为组织学上非特异性的机化性肺炎，CLL为偶然发现。6例患者有培养结果，除1例有疑似污染物外均为阴性。5例患者有肉芽肿反应，2例为坏死性肉芽肿反应，尽管培养结果为阴性。唯一一例发现可识别病原体的患者，在许多小气道中有非侵袭性真菌菌丝生长。所有患者经化疗和/或类固醇治疗后呼吸道症状均有改善，胸部X线片也显示病变消散。
