Roentgenologic diagnosis of interstitial plasma cell pneumonia in infancy

Abstract

Sixt-two series of radiographs were analyzed. Interstitial plasma cell pneumonia (IPCP) was divided into six radiographic stages. A schematic description of these stages is given. The correlation between this scheme and the actual radiographs is illustrated with a series of nine antero-posterior and lateral radiographs from one infant. The patterns of the individual stages of the disease are then discussed with the aid of pulmonary radiographs of 12 infants and one 12-month-old child with dysgammaglobulinemia. From a prospective and retrospective analysis of these radiographs, we could delineate the development of the disease from the earliest radiologically recognizable lesions to resolution. The long incubation time of IPCP was established by a retograde analysis of several series of radiographs of proved cases; the time interval was determined between the earliest recognizable change and the full-blown picture of stage V, in which the interstitial infiltrative process may be accompained by various degrees of emphysema, edema (used synoymously with alveolar filling process), pneumothorax, and madiastinal emphysema. This scheme has proved its value during 20 years of radiographic diagnostic pactice with 30-35 annual consultations concerning IPCP; IT CORRELATES WELL WITH THE CLINICAL SYMPTOMATOLOGY AND THE RESPONSE TO THERAPY. Points of differential diagnostic importance concerning other interstitial infiltrative processes of the lungs are discussed for every stage of the disease.