Clinicomorphyological peculiarities of pneumonias complicating the course of oncohematological diseases

2006 
: The modern concept of pneumonia should not be considered to be a logically accomplished theory. The diagnostic aspects remain complicated; the reasons for an increasing frequency of complication and lethality are not quite clear. Hospital pneumonia is under careful study, which is connected with its severity, complications, high lethargy, and a significantly higher cost of treatment. The morphological peculiarities of pneumonia in myelodepressed oncohematological patients deserve to be studied. In this study, 73 postmortem records of patients who had died of hemoblastoses and had had pneumonia were analyzed. The study showed that the first place in the clinical manifestations of pneumonia in myelo-depressed patients with hematoblastomas belongs to respiratory failure and toxic infective syndrome, which makes difficulties for diagnostic search of the infective process localization. Chest radiograms do not always make it possible to verify an inflammatory process in the lung tissue. Lung tissue infiltration in patients with myelodepression is within the limits of anatomic structures, which is also explained by the absence of cell elements forming the inflammatory bank. This morphological study demonstrates the absence of classic histological picture of pneumonia in the form of neutrophilic infiltration in patients with myelodepression, which often leads to the diagnosis of pulmonary edema or hemorrhage. Matching of clinicoradiological picture to the data of histological studies of the autopsy samples suggests that pneumonia in patients with myelodepression is atypical and implies forming serohemorrhagic and/or fibrinogenous exudate in the alveols.
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