Simmons J T, Suffredini A F, Lack E E, Brenner M, Ognibene F P, Shelhamer J H, Lane H C, Fauci A S, Masur H
AJR Am J Roentgenol. 1987 Aug;149(2):265-8. doi: 10.2214/ajr.149.2.265.
Chest radiographic abnormalities in patients with AIDS usually are associated with opportunistic infection or neoplasm. One hundred five patients with AIDS and clinical evidence of pneumonitis had chest radiographs and underwent bronchoscopy with bronchoalveolar lavage, transbronchial biopsy, or open-lung biopsy. Chest radiographs were abnormal in 73 (70%). Pneumocystis carinii pneumonia was identified at bronchoscopy or open-lung biopsy in 52 (50%). Nonspecific interstitial pneumonitis occurring in the absence of an identifiable infection was documented histologically in 36 (34%). Twenty (56%) of these 36 patients had abnormal chest radiographs. No currently recognized infectious agents were recovered from lavage fluid or were seen histopathologically in patients with nonspecific interstitial pneumonitis. The results show that nonspecific interstitial pneumonitis is clinically and radiologically indistinguishable from Pneumocystis carinii pneumonitis and should be considered in the differential diagnosis of AIDS patients with interstitial infiltrates.
艾滋病患者的胸部X线异常通常与机会性感染或肿瘤有关。105例有肺炎临床证据的艾滋病患者进行了胸部X线检查，并接受了支气管镜检查及支气管肺泡灌洗、经支气管活检或开胸肺活检。胸部X线检查异常的有73例（70%）。在支气管镜检查或开胸肺活检中确诊为卡氏肺孢子虫肺炎的有52例（50%）。组织学证实36例（34%）在无明确感染的情况下发生了非特异性间质性肺炎。这36例患者中有20例（56%）胸部X线检查异常。在非特异性间质性肺炎患者的灌洗液中未发现目前已知的感染病原体，组织病理学检查也未发现。结果表明，非特异性间质性肺炎在临床和放射学上与卡氏肺孢子虫肺炎难以区分，在对有间质性浸润的艾滋病患者进行鉴别诊断时应予以考虑。
