INTRATHORACIC LYMPHOPROLIFERATIVE DISORDERS IN THE IMMUNOCOMPROMISED - CT FINDINGS

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.