Honda O, Johkoh T, Ichikado K, Tomiyama N, Maeda M, Mihara N, Higashi M, Hamada S, Naito H, Yamamoto S, Nakamura H
Department of Radiology, Osaka University Medical School, Suita, Japan.
AJR Am J Roentgenol. 1999 Jul;173(1):71-4. doi: 10.2214/ajr.173.1.10397102.
Lymphoproliferative disorders span a spectrum from inflammatory lesions to malignant neoplasms. The purpose of this study was to compare high-resolution CT findings of lymphocytic interstitial pneumonia with those of malignant lymphoma of the chest.
The study included 17 patients with lymphocytic interstitial pneumonia and 44 patients with malignant lymphoma (35 with non-Hodgkin's lymphoma and nine with Hodgkin's disease). Without knowledge of the pathologic diagnosis, two chest radiologists evaluated the frequency and distribution of high-resolution CT findings in both groups of patients.
Cysts were more common in patients with lymphocytic interstitial pneumonia (14/17, 82%) than in patients with malignant lymphoma (1/44, 2%) (p < .0001). Air-space consolidation was more commonly seen in patients with malignant lymphoma (29/44, 66%) than in patients with lymphocytic interstitial pneumonia (3/17, 18%) (p < .001). Large nodules (11-30 mm in diameter) were more common in patients with malignant lymphoma (41%) than in patients with lymphocytic interstitial pneumonia (6%). Pleural effusions (25%) were seen only in patients with malignant lymphoma. We found no statistically significant difference in the distribution of lung lesions between patients with lymphocytic interstitial pneumonia and patients with malignant lymphoma.
On high-resolution CT, cysts are characteristic in patients with lymphocytic interstitial pneumonia, whereas consolidation, large nodules, and pleural effusions are characteristic in patients with malignant lymphoma. These findings on high-resolution CT help differentiate lymphocytic interstitial pneumonia from malignant lymphoma.
淋巴增生性疾病涵盖从炎症性病变到恶性肿瘤的一系列范围。本研究的目的是比较淋巴细胞间质性肺炎与胸部恶性淋巴瘤的高分辨率CT表现。
本研究纳入了17例淋巴细胞间质性肺炎患者和44例恶性淋巴瘤患者（35例非霍奇金淋巴瘤和9例霍奇金病）。在不知病理诊断的情况下，两位胸部放射科医生评估了两组患者高分辨率CT表现的频率和分布。
囊肿在淋巴细胞间质性肺炎患者中更为常见（14/17，82%），而在恶性淋巴瘤患者中较少见（1/44，2%）（p <.0001）。气腔实变在恶性淋巴瘤患者中更常见（29/44，66%），而在淋巴细胞间质性肺炎患者中较少见（3/17，18%）（p <.001）。大结节（直径11 - 30 mm）在恶性淋巴瘤患者中更常见（41%），而在淋巴细胞间质性肺炎患者中较少见（6%）。胸腔积液（25%）仅见于恶性淋巴瘤患者。我们发现淋巴细胞间质性肺炎患者和恶性淋巴瘤患者肺部病变的分布没有统计学上的显著差异。
在高分辨率CT上，囊肿是淋巴细胞间质性肺炎患者的特征表现，而实变、大结节和胸腔积液是恶性淋巴瘤患者的特征表现。高分辨率CT上的这些表现有助于区分淋巴细胞间质性肺炎和恶性淋巴瘤。
