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Pulmonary involvement in pediatric lymphoma.
Katherine E Maturen1, Caroline E Blane, Peter J Strouse
1Department of Radiology, University of Michigan Health Systems, 1500 E. Medical Center Drive/F3505, Ann Arbor, MI 48109-0030, USA.
Pediatric Radiology
|November 8, 2003
Summary
Pulmonary lymphoma is more common in children with Hodgkin disease (HD), non-Hodgkin lymphoma (NHL), and post-transplant lymphoproliferative disorder (PTLD) than previously thought. This 13% prevalence highlights the need for vigilance in diagnosing lung involvement in pediatric lymphoma patients.
Area of Science:
- Pediatric Oncology
- Pulmonary Medicine
- Radiology
Background:
- Pulmonary lymphoma prevalence in pediatric patients is not well-documented.
- Children with hematologic malignancies are at risk for extranodal disease.
- Early identification of pulmonary involvement is crucial for treatment.
Purpose of the Study:
- To determine the prevalence of pulmonary parenchymal lymphoma in children.
- To assess involvement in Hodgkin disease (HD), non-Hodgkin lymphoma (NHL), and post-transplant lymphoproliferative disorder (PTLD).
Main Methods:
- Retrospective analysis of 161 pediatric lymphoma patients over 10 years.
- Defined pulmonary lymphoma excluding isolated pleural or mediastinal disease.
- Utilized CT imaging findings for diagnosis.
Main Results:
- Overall pulmonary parenchymal lymphoma prevalence was 13% (21/161).
- Prevalence by subtype: 12% in HD, 10% in NHL, 29% in PTLD.
- Common CT findings included nodules (90%), masses (38%), and interstitial disease (9%).
Conclusions:
- Pediatric pulmonary lymphoma is more prevalent than expected, impacting patient management.
- New pulmonary lesions in lymphoma patients warrant suspicion, especially in immunocompromised individuals.
- Consider biopsy for lesions unresponsive to infection treatment to rule out lymphoma.