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Intrathoracic lymphoproliferative disorders in the immunocompromised patient: CT findings
S Carignan1, C A Staples, N L Müller
1Department of Radiology, University of British Columbia, Vancouver, Canada.
Insights
Computed tomographic (CT) findings of intrathoracic lymphoproliferative disorders in immunocompromised patients are often similar, regardless of acquired immunodeficiency syndrome (AIDS) status. These conditions typically manifest as extranodal disease.
Area of Science:
- Radiology
- Oncology
- Immunology
Background:
- Immunocompromised patients are susceptible to various lymphoproliferative disorders.
- Intrathoracic involvement can occur in these conditions.
- Accurate imaging is crucial for diagnosis and management.
Purpose of the Study:
- To evaluate computed tomographic (CT) characteristics of intrathoracic lymphoproliferative disorders.
- To differentiate findings in patients with and without acquired immunodeficiency syndrome (AIDS).
Main Methods:
- Retrospective review of chest CT scans from 18 immunocompromised patients.
- Pathological confirmation of intrathoracic lymphoproliferative disorders.
- Categorization based on underlying condition (AIDS, immunosuppressive therapy).
Main Results:
- Diffuse ground-glass opacities seen in lymphoid hyperplasia and lymphocytic interstitial pneumonia (LIP).
- Post-transplantation lymphoproliferative disorders (PTLDs) presented as nodules, often with a ground-glass halo.
- Lymphoma typically showed nodules with or without consolidation; mediastinal lymphadenopathy was noted in some PTLD and lymphoma cases.
Conclusions:
- CT findings of intrathoracic lymphoproliferative disorders are generally similar in immunocompromised patients, irrespective of AIDS.
- These disorders frequently present as extranodal disease on CT imaging.
Purpose:
To assess the computed tomographic (CT) findings of intrathoracic lymphoproliferative disorders in the immunocompromised patient.
Materials And Methods:
The authors retrospectively reviewed CT scans of the chest in 18 consecutive patients with pathologically proved intrathoracic lymphoproliferative disorders. Twelve patients had the acquired immunodeficiency syndrome (AIDS), and six were receiving immunosuppressive therapy. Final diagnosis included AIDS-related diffuse lymphoid hyperplasia (n = 1), lymphocytic interstitial pneumonia (LIP) (n = 3), posttransplantation lymphoproliferative disorders (PTLDs) (n = 4), and lymphoma (n = 10).
Results:
Diffuse areas of ground-glass attenuation were found in the patient with lymphoid hyperplasia and the three patients with LIP. The four patients with PTLDs had multiple, well-circumscribed pulmonary nodules, and nodules in three of the four patients had a halo of ground-glass attenuation. Nine of the 10 patients with lymphoma had well-circumscribed nodules or nodules with consolidation. Mediastinal lymph node enlargement was present in two patients with PTLDs and three patients with lymphoma.
Conclusion:
The intrathoracic CT findings of lymphoproliferative disorders appear to be similar in immunocompromised patients with and without AIDS and are usually extranodal.