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Primary pulmonary lymphoma: imaging findings in 30 cases

  • Chest Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

To present our experience of cases of primary pulmonary lymphoma (PPL) found between January 2002 and July 2018, focusing on the radiological features and the differential diagnosis in order to contribute to the difficult role of the radiologist in the disease identification and to help the clinicians to reach the diagnosis.

Materials and methods

CT scans of 30 patients (14 men and 16 women, aged 58–86, mean age 72 years) with PPL were retrospectively reviewed. All patients had a histopathological confirmation of the disease: MALT lymphoma (23 patients, 76.6%); diffuse large B-cell lymphoma—DLBCL (seven patients, 23.4%). All the staging CT scans were evaluated by three experienced radiologists dedicated to thoracic disease in order to radiologically define the predominant pattern of presentation.

Results

The following parenchymal patterns were observed: 11 patients with single/multiple nodules, five with masses/mass-like consolidations, 14 with consolidations with air bronchogram, 16 with ground-glass opacity, ten with angiogram sign, 22 with perilymphatic and/or peribronchovascular spread, 15 with associated lymphadenopathies, and 13 with pleural/chest wall involvement. The main characteristics of PPLs were the presence of consolidations and ground-glass opacities, with perilymphatic and/or bronchovascular spread.

Conclusion

All the characteristics of the work should alert the radiologist to consider lymphoma among the possible differential diagnoses, always correlating the results of the CT examination with appropriate clinical laboratory evaluations.

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Authors and Affiliations

  1. Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy

    Diletta Cozzi, Catia Dini, Francesco Mungai & Vittorio Miele

  2. Haematology Unit - Department of Oncology, University Hospital Careggi, Florence, Italy

    Benedetta Puccini

  3. Haematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy

    Luigi Rigacci

Authors
  1. Diletta Cozzi
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  2. Catia Dini
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  3. Francesco Mungai
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  4. Benedetta Puccini
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  5. Luigi Rigacci
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  6. Vittorio Miele
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Correspondence to Vittorio Miele.

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The Authors declare that they have no conflict of interest related to the publication of this article.

Ethical approval

The study protocol was submitted and approved by the Ethics Committee of our referring centre (CEAVC n. 13937). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cozzi, D., Dini, C., Mungai, F. et al. Primary pulmonary lymphoma: imaging findings in 30 cases. Radiol med 124, 1262–1269 (2019). https://doi.org/10.1007/s11547-019-01091-z

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