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本文报告1例高白细胞ANLL合并急性呼吸衰竭应用肺扫描结果,认为此类患者肺扫描正常时应考虑有肺白细胞郁滞综合征(PLS)存在。病例:女性,61岁,发热(39℃),呼吸急促,肝脾中度肿大,白细胞82×10~9/L,幼稚细胞95%(Auer小体),血小板37×10~9/L,骨穿形态学、细胞化学及血流细胞计数分析确诊为ANLL(M_1)。开始化疗,12小时后患者诉胸骨下疼痛、呼吸困难;查体:轻度紫绀,心动过速,呼吸急促,胸部听诊无异常;动脉血气分析为低氧、低碳酸血症、代谢性酸中毒;胸片正常,肺扫描无缺损区。病人情况恶化,嗜睡、意识不清,无神经系定位体征。胸部X线追踪示结节性广泛浸润。施行白细胞分离术,
This article reports a case of high white blood cell ANLL combined with acute respiratory failure lung scan results, that such patients should be considered normal pulmonary scintigraphy with pulmonary leukocyte syndrome (PLS) exists. Cases: Female, 61 years old, fever (39 ° C), shortness of breath, moderate enlargement of liver and spleen, leukocyte 82 × 10-9 / L, blasts 95% (Auer body), platelets 37 × 10-9 / L , Bone wear morphology, cytochemistry and blood flow cytometry analysis was confirmed as ANLL (M_1). The patients started to have sternal pain and difficulty breathing after 12 hours. Physical examination: mild cyanosis, tachycardia, shortness of breath, no abnormality in chest and auscultation. Arterial blood gas analysis was hypoxemia, hypocapnia, metabolic acidosis ; Chest radiograph normal, lung defect-free area. Patients deteriorated, drowsiness, confusion, no signs of neurological localization. Chest X-ray showed nodular extensive infiltration. Leukocyte isolation,