Pleurisy in patients with chronic lymphoid leukemia
Aim. To establish the clinical and laboratory features of the pleurisy course in patients with chronic lymphocytic leukemia (CLL) living in the Amur Region. Materials and methods. We studied the case histories and outpatient records of 75 patients with CLL in stages B and C according to the J.Binet classification who were treated in the hematology department of the Amur Regional Clinical Hospital in 2012-2018. Results. Exudative pleurisy was found in 28 patients (37%). The most common cause of pleurisy in patients with CLL was lymphoid infiltration of the pleura (18 patients), less often - infectious pleurisy developed (10 patients). Based on the study of the peculiarities of the course of specific lymphoproliferative and infectious pleurisy, significant differences in the clinical course and laboratory data were established. With infectious pleurisy, “pleural” manifestations and clinical manifestations of pneumonia, the complication of which it was, prevailed; in laboratory examination of exudate, neutrophils prevailed. The prognosis of infectious pleurisy is favorable in most cases. The clinical picture of the tumor process prevailed in specific lymphoproliferative pleurisy, in the laboratory study of exudate - tumor lymphocytes, the hemorrhagic nature of the fluid. Specific lymphoproliferative pleurisy occurs at the stage of malignant transformation of CLL, often being its first manifestation. Conclusion. The attachment of the specific lymphoproliferative pleurisy is an unfavorable prognostic factor for patients with CLL.