[X-ray image and differential diagnosis of pulmonary changes in Hodgkin's disease]

Of 291 patients with histologically confirmed lymphogranulomatosis, 45 (15.5%) with lung involvement were assessed. 22 (49%) of the patients with affected lung had the nodular sclerosing type of Hodgkin's disease. Radiologically, 15 patients showed a focal solitary manifestation of lymphogranulomatosis, whereas in 19 patients multiple, plane or circumscript areas of shadow were seen in one or both lobes of the lung. 11 further patients had unilateral or bilateral pleural effusions. Nodular (35%) and pneumonic (22%) opacities are the most frequent x-ray manifestations of pulmonary lymphogranulomatosis. The variable appearance of the lesions makes it difficult to differentiate against pulmonary infections, especially inflammatory complications, the incidence of which may be higher with these patients. In view of the far-reaching consequences, therefore, the nature of the pulmonary lesions should be clarified by biopsy in case of doubt, as early as possible (transbronchial biopsy and, if necessary, open lung biopsy).