One of the most severe manifestations of chronic lymphocytic leukemia is exudative pleurisy. Its nature can be different: a couple or metapneumonic pleurisy with a banal infection, tuberculosis pleurisy, lymphatic infiltration of the pleura, compression or rupture of the thoracic lymphatic duct. Infectious pleurisy is most often a complication of pneumonia . In the exudate, along with lymphocytes, there are many neutrophils . In case of compression or rupture of the thoracic lymphatic duct, the exudate will be lymphatic, but the fluid will contain large amounts of fat a (malignant fluid) .
The most frequently encountered specific lymphoproliferative pleurisy as a manifestation of lymphoid pleural infiltration . Diagnostics of lymphoproliferative pleurisy is supported by computed tomography. With CT, it is often possible to detect tumor growth in the pleura, infiltration or sarcoma nodes . The treatment of specific lymphoproliferative pleurisy is complex and long-term, its adherence is an unfavorable prognostic factor for CLL patients. Topical administration of cytostatic preparations is usually not very effective . The best results are given by the general cytostatic therapy according to the schemes COP, CHOP; sometimes it is necessary to resort to irradiation of the pleura (tangentially); with a sharply enlarged spleen, splenectomy can lead to the elimination Pleurisy for many years .
In the literature, there is a small number of works covering the course of chronic obstructive pulmonary disease (COPD) in patients with chronic lymphoproliferative diseases. V.M. Provotorov and A.Yu. Kazabtsov (1997) examined patients with COPD with concomitant lymphoproliferative diseases – CLL, lymphocytic lymphoma, and myeloma. The authors concluded that in patients with COPD on the background of chronic lymphoproliferative tumors, a violation of the tracheobronchial cleansing is more pronounced than in patients with COPD without lymphoproliferation. The course of COPD, when combined with lymphoproliferative diseases, is characterized by slow dynamics of clinical symptoms and a more severe course . A.Yu. Ka- zabtsov (1998) found that in patients with COPD on the background of CLL, a violation of mucociliary transport is more pronounced than in patients with COPD without concomitant lymphoproliferation.
Much attention is paid to immunomodulatory therapy for CLL . It is necessary to conduct therapeutic and recreational activities for all related diseases in patients with CLL in an outpatient setting, as well as the appointment of prophylactic immunostimulating therapy in the autumn-spring period. Timely prevention and treatment of infectious complications in CLLs contributes to the prolongation of life of these patients .