Milligan S A, Stulbarg M S, Gamsu G, Golden J A
Am Rev Respir Dis. 1985 Nov;132(5):1124-6. doi: 10.1164/arrd.1985.132.5.1124.
Eight immunocompromised patients presented with upper lobe infiltrates that radiographically simulated tuberculosis. Bilateral lobar consolidation was present in 5, and apical or posterior segmental consolidation was present in 3. Pneumocystis carinii was diagnosed in 7 patients from material obtained at bronchoscopy after sputum stained for mycobacteria had been negative. In the eighth patient, sputum submitted for cytologic evaluation demonstrated P. carinii. The 7 patients surviving this episode of pneumonia responded clinically and radiographically to specific therapy directed against P. carinii. Predominant upper lobe involvement has not been previously emphasized as a pattern of P. carinii pneumonia but should be considered in immunocompromised patients.
8例免疫功能低下患者出现上叶浸润影，影像学表现类似肺结核。5例为双侧肺叶实变，3例为尖段或后段实变。7例患者在痰涂片抗酸染色阴性后，经支气管镜取材诊断为卡氏肺孢子虫肺炎。第8例患者，送检痰液的细胞学检查发现卡氏肺孢子虫。这7例肺炎患者经针对卡氏肺孢子虫的特异性治疗后，临床症状和影像学表现均有改善。以前未强调卡氏肺孢子虫肺炎以上叶受累为主的表现模式，但免疫功能低下患者应考虑这种情况。
