AIDS-related pulmonary lymphoma

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AIDS-related pulmonary lymphoma (ARPL) is classified as a distinct form of pulmonary lymphoma. Pulmonary involvement is a common extranodal site in AIDS-related NHL.

Pathology

ARPL is typically a high-grade B-cell non-Hodgkin's lymphoma and the majority of patients have advanced HIV infection, with a mean CD4 count of around 67/mm .

Diagnostic criteria

According to some publications, the diagnostic criteria for pulmonary involvement requires :

  • positive HIV status
  • histologically proven lymphomatous pulmonary involvement
  • absence of mediastinal and/or hilar adenopathy on chest radiography
  • absence of extrathoracic lymphoma extension

Radiographic features

CT - HRCT chest

Features can be variable and can include:

  • multiple peripheral well-defined nodules of varying sizes
    • usually, measure around 1-5 cm in diameter
    • reflect dense focal monomorphic cellular infiltrates
    • considered the commonest manifestation
  • centrilobular nodules
  • subpleural parenchymal infiltrative changes
  • peribronchovascular reticular infiltrative changes
  • peripheral mass-like regions (may have associated cavitation).
  • interlobular septal thickening

See also