Peripheral T-cell lymphoma: spectrum of imaging findings with clinical and pathologic features

Most radiologists are unfamiliar with peripheral T-cell lymphoma (PTCL) because PTCL represents a relatively small proportion of lymphomas and has a lower prevalence in Western countries. The World Health Organization classification of lymphoid neoplasms announced in 1999 resolved criticisms about lymphoma classification and aroused new interest in PTCL. The specific clinicopathologic entities of PTCL have particular primary locations and particular clinical and pathologic features. Radiologic images of patients with pathologically proved PTCL were retrospectively reviewed; clinical and pathologic data were also reviewed. PTCL involves various organs including the sinonasal cavity, airway, intestinal tract, skin, lymph nodes, liver, lung, and musculoskeletal system. The pattern of disease involvement in PTCL is not random. There is a correlation between specific clinicopathologic entities and the primary site of involvement, although the findings in the disseminated stage of disease do not allow differential diagnosis. It is significant that the radiologic features or locations of several entities are different from those of lymphoma with the B-cell phenotype. Radiologic demonstration of disease progression beyond the primary site is clinically important because systemic dissemination in most of the entities leads to a dramatic change in the prognosis.