Computed tomographic manifestations of pulmonary non-Hodgkin's Lymphoma

The purpose of this study is to describe computed tomography (CT) findings of pulmonary non-Hodgkin's lymphoma. Thirty-seven patients (24 to 92-years-old, mean 67, 27 males) with pulmonary non-Hodgkin's lymphoma confirmed by pathology and encountered over a period of more than 10 years were reviewed. Pulmonary specimens were obtained by CT-guided core biopsy (n=16), transbronchial biopsy (n=15) and surgery (n=6). The pathological diagnoses were mucosa-associated lymphoid tissue (MALT) lymphoma (n=19), diffuse large B cell lymphoma (DLBCL) (n=13), anaplastic cell lymphoma (n=2), mantle cell lymphoma (n=2), and Burkitt's lymphoma (n=1). The chest CT findings included consolidation (86.5%), ground glass opacity (GGO) (78.4%), air-bronchograms (70.3%), lymphadenopathy (70.3%, of which 80.8% had hilar involvement), CT-halo sign (67.6%), lung nodule (54.1%), reticular opacities (48.6%) and pleural effusion (24.3%). Of 37 cases, 30 (81.1%) had concurrence of more than 3 findings and 26 patients (70.3%) had more than 4 findings. Mediastinal lymphadenopathy was found significantly more often in cases of non-MALT rather than MALT lymphoma (p = 0.03) and more often in cases of secondary or recurrent lymphoma compared to primary NHL (p < 0.05). It is concluded that the concurrence of more than 3 findings on chest CT images should alert one to consider the possibility of lymphoma.