Primary pulmonary AIDS-related lymphoma - Radiographic and CT findings

Study objectives: To describe the radiographic and CT findings of primary AIDS-related lymphoma (ARL) of the lung (ARLL), and to evaluate percutaneous transthoracic needle biopsy (PTNB) in the diagnosis of primary,ARLL. Materials and methods: Seven chest radiographs and seven CT scans of HIV-invected patients with histologically proved primary pulmonary non-Hodgkin's lymphoma (PPL) were reviewed at our institution. All of the patients had fibroscopy with BAL. The diagnosis of PPL was established histologically by means of PT;VB (n = 4), open-lung biopsy (n = 2), or autopsy (n = 1). Results: All but one patient had multiple peripheral well-defined nodules of various sizes on the chest X-ray film and CT scan. One patient bad a subpleural parenchymal infiltrate and another had a main peripheral mass with spontaneous cavitation. Hilar/mediastinal adenopathies and pericardial/pleural effusion were never associated with the parenchymal abnormalities. Fibroscopy with BAL, was always negative. PTNB, done in six cases, was diagnostic in four cases and suggested primary ARLL in two cases. No complications occurred during these procedures, Conclusion:, After excluding infectious causes, multiple peripheral nodules and/or masses without hilar or mediastinal adenopathies and without pleural effusion are suggestive of primary pulmonary ARL, A specific diagnosis can be obtained by means of PTNB.