Lazzari Agli L, Viglietta G, Arlotti M, Ciammarughi R, Forlani S, Muratore F
Divisione di Medicina Generale, Ospedale "Infermi", Rimini.
Radiol Med. 1993 Dec;86(6):826-32.
Pneumocystis carinii pneumonia (PCP) is certainly the most frequent opportunistic pulmonary infection in AIDS patients. Besides the conventional radiographic features demonstrating bilateral infiltrates and airspace consolidation, atypical radiologic patterns are reported in the literature, which are characterized by spontaneous pneumothorax and by the presence of bullae, cysts and areas of pulmonary cavitation. Forty consecutive PCP patients were investigated, ten of them presenting with atypical radiographic findings: 1 case of spontaneous pneumothorax with no evidence of bullae and 9 cases of bullous lung disease--5 of them complicated by spontaneous pneumothorax. Several pathogenetic hypotheses were considered; lesions evolution and the differential radiologic diagnosis were discussed. As for diagnosis, the value of chest CT scans is emphasized, together with that of HRCT which is extremely valuable to localize, characterize and evaluate bullous lesions and associated parenchymal signs.
卡氏肺孢子虫肺炎（PCP）无疑是艾滋病患者中最常见的机会性肺部感染。除了传统的影像学特征显示双侧浸润和肺泡实变外，文献中还报道了非典型的放射学表现，其特征为自发性气胸以及存在肺大疱、囊肿和肺空洞区域。对40例连续性PCP患者进行了研究，其中10例呈现非典型影像学表现：1例自发性气胸且无肺大疱证据，9例为肺大疱性疾病——其中5例并发自发性气胸。考虑了几种发病机制假说；讨论了病变演变及鉴别放射学诊断。关于诊断，强调了胸部CT扫描的价值，以及高分辨率CT（HRCT）的价值，HRCT对于定位、描述和评估肺大疱病变及相关实质征象极具价值。
