Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, South Korea.
Clin Rheumatol. 2013 Oct;32(10):1459-65. doi: 10.1007/s10067-013-2304-5. Epub 2013 Jun 2.
Lymphoproliferative disorders (LPDs) may involve intrathoracic organs in patients with autoimmune disease, but little is known about the radiologic manifestations of autoimmune disease-associated LPDs (ALPDs) of the lungs. The purpose of our work was to identify the radiologic characteristics of pulmonary involvement in ALPDs. A comprehensive search for PubMed database was conducted with the combination of MeSH words. All articles which had original images or description on radiologic findings were included in this analysis. Also, CT images of eight patients with biopsy-proven lymphoproliferative disorder observed from our institution were added. Overall, 44 cases of ALPD were identified, and consisted of 24 cases of bronchus-associated lymphoid tissue lymphoma (BALToma), eight cases of non-Hodgkin's lymphoma (NHL), six cases of lymphoid interstitial pneumonia (LIP), two cases of nodular lymphoid hyperplasia, two cases of unclassified lymphoproliferative disorder, and one case each of lymphomatoid granulomatosis and hyperblastic BALT. Multiple nodules (n = 14, 32 %) and single mass (n = 8, 18 %) were the predominant radiologic manifestations. The imaging findings conformed to previously described findings of BALToma, NHL, or LIP. Data suggest that BALToma, NHL, and LIP are the predominant ALPDs of the lung, and ALPD generally shared common radiologic features with sporadic LPDs. Familiarity with ALPDs and their imaging findings may enable radiologists or clinicians to include the disease as a potential differential diagnosis and thus, to prompt early biopsy followed by appropriate treatment.
淋巴组织增生性疾病(LPDs)可能累及自身免疫性疾病患者的胸内器官,但关于与自身免疫相关的肺部 LPD(ALPD)的放射学表现知之甚少。我们的工作目的是确定 ALPD 肺部受累的放射学特征。我们通过组合 MeSH 词对 PubMed 数据库进行了全面搜索。所有包含放射学发现原始图像或描述的文章都包含在本分析中。此外,还添加了我院观察到的 8 例经活检证实的淋巴组织增生性疾病患者的 CT 图像。总的来说,确定了 44 例 ALPD,包括 24 例支气管相关淋巴组织淋巴瘤(BALToma)、8 例非霍奇金淋巴瘤(NHL)、6 例淋巴间质肺炎(LIP)、2 例结节性淋巴组织增生、2 例未分类的淋巴组织增生性疾病,以及 1 例淋巴瘤样肉芽肿病和增生性 BALT。主要的放射学表现为多发结节(n = 14,32%)和单发肿块(n = 8,18%)。影像学表现与先前描述的 BALToma、NHL 或 LIP 相符。数据表明,BALToma、NHL 和 LIP 是肺部 ALPD 的主要类型,并且 ALPD 通常与散发性 LPD 具有共同的放射学特征。熟悉 ALPD 及其影像学表现可以使放射科医生或临床医生将其作为潜在的鉴别诊断,从而促使进行早期活检,然后进行适当的治疗。