Ms. Dai et al., Impact of open lung biopsy for undiagnosed pulmonary infiltrates in patients with hematological malignancies, AM J HEMAT, 68(2), 2001, pp. 87-90
Pulmonary complications are frequently encountered in patients with hematol
ogical malignancy. The optimal therapeutic decision including open lung bio
psy (OLB) for such patients is uncertain. We herein examine the clinical im
pact of OLB on these patients. Seven patients with progressively diffuse pu
lmonary infiltrates despite aggressive medical treatment were examined. The
underlying diseases, prior treatment for presumptive pneumonia, the change
in therapeutic approach after operation, and clinical outcome were reviewe
d retrospectively. Diffuse pulmonary infiltrates were caused by infection i
n two patients and by noninfectious etiology such as alveolar proteinosis,
idiopathic interstitial pneumonitis, leukemic involvement, and drug-induced
alveolar damage in the others. Four patients who had serious underlying he
matologic diseases such as myelodysplastic syndrome, acute and chronic myel
oid leukemia, and T cell lymphoma died. Three patients with acute lymphoid
leukemia survived. In two of these three, change of therapeutic strategies
after OLB was created for the survival. OLB in patients with hematological
malignancy may be useful in selected patients with a treatable hematologic
disease who have treatable underlying causes of the pulmonary infiltrate. A
m. J. Hematol. 68:87-90, 2001. (C) 2001 Wiley-Liss, Inc.