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目的探讨儿童急性白血病合并卡氏肺囊虫肺炎早期诊断的方法。方法2001年1月至2004年3月,天津市儿童医院对5例急性白血病和恶性淋巴瘤合并卡氏肺囊虫肺炎(PCP)患儿的临床表现、实验室检查、胸部X线平片及胸部CT检查资料进行分析,寻找可能的早期诊断的方法。结果1例胸部平片表现无异常,而CT显示两肺细线状和网状影像。其余4例胸部平片表现异常,同期CT显示双侧肺叶病灶数目和范围均有所增多,主要为小叶间隔和小叶内间质增厚及支气管血管束增粗。结论PCP患儿最初X线平片可显示正常,而CT改变的出现早于X线平片。胸部CT检查在白血病合并PCP的早期诊断中具有重要价值。
Objective To investigate the early diagnosis of Pneumocystis carinii pneumonia in children with acute leukemia. Methods From January 2001 to March 2004, Tianjin Children’s Hospital studied the clinical manifestations, laboratory tests, chest radiographs and chest X-ray in 5 children with acute leukemia and malignant lymphoma complicated with Pneumocystis carinii pneumonia (PCP) Chest CT examination data analysis, looking for possible early diagnosis. Results 1 case of chest plain film showed no abnormalities, and CT showed thin line of both lungs and reticular images. The other 4 cases of chest plain film showed abnormalities, simultaneous CT showed bilateral lesion number and range have increased, mainly for the interlobular septa and interstitial thickening and bronchovascular bundle thickening. Conclusion The initial radiographs of PCP can show normal, while the CT changes appear earlier than plain radiographs. Chest CT examination in the early diagnosis of leukemia combined with PCP has important value.