Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Radiol. 2023 Apr;24(4):362-370. doi: 10.3348/kjr.2022.0844. Epub 2023 Feb 16.
To report the clinical and radiological characteristics of patients with underlying B-cell lymphoma and coronavirus disease 2019 (COVID-19) showing migratory airspace opacities on serial chest computed tomography (CT) with persistent COVID-19 symptoms.
From January 2020 to June 2022, of the 56 patients with underlying hematologic malignancy who had undergone chest CT more than once at our hospital after acquiring COVID-19, seven adult patients (5 female; age range, 37-71 years; median age, 45 years) who showed migratory airspace opacities on chest CT were selected for the analysis of clinical and CT features.
All patients had been diagnosed with B-cell lymphoma (three diffuse large B-cell lymphoma and four follicular lymphoma) and had received B-cell depleting chemotherapy, including rituximab, within three months prior to COVID-19 diagnosis. The patients underwent a median of 3 CT scans during the follow-up period (median 124 days). All patients showed multifocal patchy peripheral ground glass opacities (GGOs) with basal predominance in the baseline CTs. In all patients, follow-up CTs demonstrated clearing of previous airspace opacities with the development of new peripheral and peribronchial GGO and consolidation in different locations. Throughout the follow-up period, all patients demonstrated prolonged COVID-19 symptoms accompanied by positive polymerase chain reaction results from nasopharyngeal swabs, with cycle threshold values of less than 25.
COVID-19 patients with B-cell lymphoma who had received B-cell depleting therapy and are experiencing prolonged SARS-CoV-2 infection and persistent symptoms may demonstrate migratory airspace opacities on serial CT, which could be interpreted as ongoing COVID-19 pneumonia.
报告在连续胸部计算机断层扫描（CT）上出现移行性气腔混浊且持续出现 COVID-19 症状的潜在 B 细胞淋巴瘤和 2019 年冠状病毒病（COVID-19）患者的临床和影像学特征。
从 2020 年 1 月至 2022 年 6 月，在我院感染 COVID-19 后多次进行胸部 CT 检查的 56 例潜在血液恶性肿瘤患者中，选择了 7 例成人患者（5 例女性；年龄 37-71 岁；中位年龄 45 岁）进行分析，他们在胸部 CT 上显示出移行性气腔混浊。
所有患者均被诊断为 B 细胞淋巴瘤（3 例弥漫性大 B 细胞淋巴瘤和 4 例滤泡性淋巴瘤），在 COVID-19 诊断前 3 个月内接受了包括利妥昔单抗在内的 B 细胞耗竭化疗。在随访期间，所有患者均进行了中位数为 3 次 CT 扫描（中位数 124 天）。所有患者在基线 CT 上均显示多发性局灶性周边磨玻璃影（GGOs），以基底为主。在所有患者中，随访 CT 显示先前的气腔混浊清除，同时在不同部位出现新的周边和支气管周围 GGO 和实变。在整个随访期间，所有患者均表现出 COVID-19 症状持续时间延长，同时鼻咽拭子聚合酶链反应结果为阳性，循环阈值值小于 25。
接受 B 细胞耗竭治疗且持续感染 SARS-CoV-2 并持续出现症状的 COVID-19 患者可能在连续 CT 上出现移行性气腔混浊，这可被解释为持续的 COVID-19 肺炎。
