A rare cause of fever and PET‐positive nodules in the lungs

Rossi, Giulio; Marchioni, Alessandro; Guicciardi, Novella; Bertolini, Federica; Valli, Riccardo; Cavazza, Alberto

doi:10.1111/j.1752-699x.2008.00114.x

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…To our knowledge, only one other cases series has studied the CT appearance of pulmonary LG (7). Most descriptions of CT and fluorodeoxyglucose positron emission tomography (FDG-PET) appearance of LG were presented in isolated case reports (8-10). The purpose of our study was to analyze the CT and FDG-PET findings in patients with pathologically proven pulmonary LG.…”

Section: Introductionmentioning

confidence: 99%

Lymphomatoid Granulomatosis: CT and FDG-PET Findings

Chung

Gilman

et al. 2011

Korean J Radiol

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ObjectiveLymphomatoid granulomatosis (LG) is a rare, aggressive extranodal Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disease. The purpose of our study was to analyze the CT and fluorodeoxyglucose positron emission tomography (FDG-PET) findings of pulmonary LG.Materials and MethodsBetween 2000 and 2009, four patients with pathologically proven pulmonary LG and chest CT were identified. Two of these patients also had FDG-PET. Imaging features of LG on CT and PET were reviewed.ResultsPulmonary nodules or masses with peribronchovascular, subpleural, and lower lung zonal preponderance were present in all patients. Central low attenuation (4 of 4 patients), ground-glass halo (3 of 4 patients), and peripheral enhancement (4 of 4 patients) were observed in these nodules and masses. An air-bronchogram and cavitation were seen in three of four patients. FDG-PET scans demonstrated avid FDG uptake in the pulmonary nodules and masses.ConclusionPulmonary LG presents with nodules and masses with a lymphatic distribution, as would be expected for a lymphoproliferative disease. However, central low attenuation, ground-glass halo and peripheral enhancement of the nodules/masses are likely related to the angioinvasive nature of this disease. Peripheral enhancement and ground-glass halo, in particular, are valuable characteristic not previously reported that can help radiologists suggest the diagnosis of pulmonary LG.

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Section: Introductionmentioning

confidence: 99%

Lymphomatoid Granulomatosis: CT and FDG-PET Findings

Chung

Gilman

et al. 2011

Korean J Radiol

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Lymphoproliferative lung disorders: clinicopathological aspects

Poletti¹,

Ravaglia²,

Tomassetti³

et al. 2013

European Respiratory Review

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Lymphoproliferative disorders are rarely observed as primary lesions in the lung, representing only 0.3% of all primary pulmonary malignancies, ,1% of all the cases of non-Hodgkin lymphoma and 3-4% of all the extra nodal manifestations of non-Hodgkin lymphoma. The earliest comprehensive studies of pulmonary lymphomas were those of SALTZSTEIN [1] and PAPIOANNOU and WATSON [2], which were published in the 1960s. These investigators made important observations: low-grade neoplasms were more frequent than higher grade lymphomas (reticulum cell sarcomas) and both tumours had better clinical outcomes than their nodal-based counterparts. The authors also concluded that the majority of neoplasms with a low-grade cytological appearance should be considered as reactive proliferations, introducing the term ''pseudolymphoma''. This hypothesis showed significant weak points and, approximately 20 years later, ADDIS et al. [3] concluded that ''most if not all the cases of pseudo-lymphoma can be classified, when re-evaluated, as malignant lymphoma''. Knowledge of these entities expanded rapidly after the advent of new investigative tools such as immunohistochemistry and molecular biology techniques. The World Health Organization (WHO) classification of lymphoid neoplasm recently emphasised the importance of clinical features [4]. Table 1 provides an overall classification of lymphoproliferative disorders, which are described as: reactive/nonneoplastic lymphoid lesions, malignant parenchymal lymphoproliferative lesions (primary or secondary) and post-transplant lymphoproliferative disorders. Pathological aspectsReactive pulmonary lymphoid diseases Three rare forms of benign hyperplasia of pulmonary lymphoid tissue, namely follicular bronchiolitis, pulmonary nodular lymphoid hyperplasia and lymphocytic interstitial pneumonia, are regarded as part of the spectrum of lymphoid hyperplasia of the bronchus-associated lymphoid tissue (table 1) [5,6]. Follicular bronchiolitis is characterised by lymphoid follicular hyperplasia, often with reactive germinal centres, in the walls of bronchioles with narrowing of the lumen. Pulmonary nodular lymphoid hyperplasia (pulmonary pseudo-lymphoma) is a distinct form of reactive lymphoid proliferation with links to the family of IgG4-related sclerosing diseases, characterised by a dense nodular infiltration of mature, polyclonal lymphocytes and plasma cells, which are well-circumscribed and mainly sub-pleural, with some dense fibrosis between

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