McGuinness G, Scholes J V, Jagirdar J S, Lubat E, Leitman B S, Bhalla M, McCauley D I, Garay S M, Naidich D P
Department of Radiology, New York University Medical Center, NY 10016, USA.
Radiology. 1995 Oct;197(1):59-65. doi: 10.1148/radiology.197.1.7568855.
To identify characteristic computed tomographic (CT) findings in unusual pulmonary lymphoproliferative disorders seen in adults with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).
The authors retrospectively reviewed the CT scans and pathologic specimens from nine patients with pulmonary lymphoproliferative disorders. CT scans were evaluated for nodules, reticulation, areas of ground-glass attenuation, consolidation, and bronchial disease. Changes seen in pathologic specimens were classified as consistent with classic lymphocytic interstitial pneumonitis (LIP), mucosa-associated lymphoid tissue lymphoma (MALTOMA), or atypical lymphoproliferative disorder (ALD). Immunopathologic results were reviewed when available.
Eight patients had AIDS. Five patients had classic LIP. One patient had MALTOMA, and three patients had ALD. Altogether, 2-4-mm-diameter nodules were the predominant CT finding in eight patients; these were peribronchovascular in four patients. The presence of interstitial nodules correlated with the pathologic finding of nodular disease in seven patients.
Familiarity with these AIDS-related disorders and their CT appearance should assist in the differential diagnosis.
确定成人人类免疫缺陷病毒(HIV)或获得性免疫缺陷综合征(AIDS)患者中罕见的肺淋巴增殖性疾病的特征性计算机断层扫描(CT)表现。
作者回顾性分析了9例肺淋巴增殖性疾病患者的CT扫描和病理标本。对CT扫描评估结节、网状影、磨玻璃影区域、实变及支气管病变情况。病理标本所见变化分为符合经典淋巴细胞间质性肺炎(LIP)、黏膜相关淋巴组织淋巴瘤(MALTOMA)或非典型淋巴增殖性疾病(ALD)。如有免疫病理结果也进行回顾分析。
8例患者患有AIDS。5例患者有经典LIP。1例患者有MALTOMA,3例患者有ALD。总体而言,直径2 - 4 mm的结节是8例患者主要的CT表现;其中4例位于支气管血管周围。7例患者间质结节的存在与结节性病变的病理表现相关。
熟悉这些与AIDS相关的疾病及其CT表现有助于鉴别诊断。