Computed tomography features of primary pulmonary non-Hodgkin's lymphoma

To characterize computed tomography (CT) features of primary pulmonary lymphoma (PPL).

The CT films of six patients (five men, one woman; 63.2 +/- 14.5 years) with low grade non-Hodgkins PPL were evaluated for alveolar opacities (lobar consolidation, masses or nodules, and ill-defined consolidations), peribronchial disease or bronchial wall thickening, mediastinal nodes and pleural effusion.

Multilobar bilateral, multilobar unilateral, and unilobar unilateral involvement were present in three, one and two cases respectively. CT features were: ill-defined mainly subpleural consolidations (n = 4), mass-like consolidation (n = 1), lobar consolidation (n = 1), and pleural effusion (n = 1). Minor peribronchial disease was seen in two patients, heterogeneous enhancement in four patients, and CT-angiogram sign in one patient. There were no lymphadenopathy or lung nodules. Although the pleura were inseparable from subpleural disease, pleural enhancement was noted on magnetic resonance imaging (MRI) of a patient with lobar lymphoma.

PPL is characterized by ill-defined alveolar opacities that are usually multifocal. Peribronchial disease, proximal bronchiectasis and positive CT-angiogram sign are ancillary features. MRI may be useful in further evaluation with respect to pleural or chest wall involvement.