The clinical characteristics of the bronchopulmonary system in patients with CLL, outside the administration of AML, depended on the stage of the disease. In patients of group I, peripheral lymph nodes were not enlarged and, according to x-ray studies, no increase in lymph nodes in the chest cavity was detected. In all patients of this group, the lower edge of the liver was palpated along the edge of the rib arc; the spleen was not detected by palpation. In patients of group I, the chest was the correct form, both of its halves equally participated in the act of breathing. A clear pulmonary sound was determined perkutorno over the entire lung surface, vesicular respiration was heard during auscultation, and there were no spurious respiratory sounds. In 4 patients with the presence of concomitant Nedo sufficiency blood circulation in the lower parts of the lungs during auscultation listened to wet fine bubbling rales, percussion determined the dullness of the pulmonary sound.
In 80 patients of group II (71%), according to x-ray methods, an increase in broncho-pulmonary and mediastinal lymph nodes was diagnosed. However, none of the patients showed clinical symptoms of compression of the bronchi and lung tissue due to an increase in the lymph nodes in the chest cavity. In 61 patients, an increase in the spleen and / or liver was diagnosed, but there were no clinical signs of compression syndrome. When viewed in 82 patients of group II, the chest was the correct form. In 72 patients, during a percussion, a clear pulmonary sound was detected over the entire lung surface, vesicular respiration was heard during auscultation, and there were no adverse respiratory sounds.In 10 patients with the presence of concomitant circulatory failure in the lower lung during auscultation listened to wet finely wheezing, percussion determined the dullness of the pulmonary sound.
All patients in group III were diagnosed with swollen lymph nodes, including in the chest cavity. Of these, 14, according to peripheral lymph node biopsy, were diagnosed with Richter syndrome (transformation into large cell lymphoma).