pulmonary manifestations of lymphoma

Pulmonary lymphoma refers to lung parenchymal involvement with lymphoma.

Pathology

It can be broadly divided as primary or secondary:

  • primary pulmonary lymphoma: (rare) usually non-Hodgkin lymphoma which is limited to the lung with or without mediastinal lymph node involvement and with no evidence of extrathoracic dissemination for at least 3 months after the initial diagnosis
    • low-grade B-cell lymphoma (MALToma) - commonest ~ 80% of primary pulmonary lymphoma
    • high-grade B-cell lymphoma - most commonly B-cell, occasionally anaplastic and peripheral T-cell types
    • primary pulmonary plasmacytoma (rare)
    • pulmonary intravascular lymphoma (rare)
    • angiocentric immunoproliferative lesion (lymphomatoid granulomatosis)
  • secondary pulmonary lymphoma: relatively common

Two additional categories have also been described which include :

Radiographic features

CT

A number of features may be present on HRCT which include:

  • a mass or mass-like consolidation greater than 1 cm with or without cavitations or bronchograms - most common finding according to one study
  • masses of pleural origin
  • nodules <1 cm
  • alveolar or interstitial infiltrates
  • peribronchial or perivascular thickening with or without atelectasis
  • pleural effusions
  • hilar or mediastinal lymphadenopathy

See also