Abstract
Pulmonary complications were studied in 213 patients with leukemia and lymphoma. The incidence of pulmonary lesions was 38.5% and diffuse changes were encountered twice more frequently than localized ones. Etiological diagnosis during life was difficult. In 38 out of 62 cases with diffuse lesions, their etiology was not determined. In 9 out of 28 cases with localized lesions their etiology was not clear. In some of these cases autopsy clarified their etiology.
Among localized cases, infection, mainly of bacterial origin and infiltration of underlying diseases were two main etiologies. On the other hand, diffuse lung lesions were of various etiology; 29 infections (bacteria 8, fungus 9, virus 8, p.carinii 2), 11 tumor infiltrations, 11 interstitial pneumonia, 3 vascular origins. In these cases with diffuse lesions of different etiology, clinical findings such as fever, cough, dyspnea, low PO2, high LDH, increased CRP, and hypoalbuminemia were observed, but not helpful in differentiating the etiology. Eight out of 11 cases of interstitial pneumoonia occurred during or after tapering of glucocorticoid.
The mortality rate was as high as 54.4% of all lung diseases. Retrospective studies on the chest X-ray pictures showed that diffuse ill-defined opacities or multilocated consolidations were associated with poor prognosis.
The diagnostic value of transbronchoscopic lung biopsy and therapeutic implications of empirical glucocorticoid administration for etiologically undiagnosed lung lesions were also discussed.
