Wise R H, Shin M S, Gockerman J P, Zornes S L, Rubin E, Nath P H
AJR Am J Roentgenol. 1984 Oct;143(4):707-14. doi: 10.2214/ajr.143.4.707.
The radiographic, pathologic, and clinical features of 22 episodes of pneumonia in 18 bone marrow transplant recipients were analyzed retrospectively. These pneumonias could be divided into three diagnostic categories: (1) a transient form of nonspecific interstitial pneumonia resembling pulmonary edema in radiographic appearance occurred in five patients during the first 2 weeks after transplantation; (2) a fatal, progressive form of interstitial pneumonia began from 2 weeks to several months after bone marrow transplantation in seven patients; and (3) airspace pneumonias occurred in nine patients within 2 months of transplantation and were uniformly fatal. While the temporal and radiographic presentation of transient early interstitial pneumonia is often characteristic and may not require biopsy for diagnosis, the airspace and progressive interstitial pneumonias affecting bone marrow transplant recipients present variable patterns that are often radiographically indistinguishable. The direct pulmonary toxicity of high-dose total-body irradiation and chemotherapy may be contributory in producing both the early transient and later progressive forms of nonspecific interstitial pneumonia.
对18例骨髓移植受者发生的22次肺炎的影像学、病理学和临床特征进行了回顾性分析。这些肺炎可分为三个诊断类别：（1）5例患者在移植后的前2周出现了一种短暂的非特异性间质性肺炎，其影像学表现类似肺水肿；（2）7例患者在骨髓移植后2周数月出现了一种致命的、进行性间质性肺炎；（3）9例患者在移植后2个月内发生了气腔性肺炎，均为致命性。虽然短暂性早期间质性肺炎的发病时间和影像学表现通常具有特征性，可能无需活检即可诊断，但影响骨髓移植受者的气腔性肺炎和进行性间质性肺炎呈现出多种模式，在影像学上往往难以区分。大剂量全身照射和化疗对肺部的直接毒性可能是导致早期短暂性和后期进行性非特异性间质性肺炎的原因。
