CT findings and differential diagnosis of primary pulmonary lymphoma

ZHENG Zhengyu; WANG Ximing; HU Chunhong

Abstract：Objective To study the spiral CT findings of primary pulmonary lymphoma (PPL), in order to improve the diagnostic accuracy.Methods CT datas of 18 patients with confirmed PPL with pathology were retrospectively analyzed.Results Pulmonary lesions were depicted as solitary nodule in 4 patients, mass in 8 patients, segmental consolidation in 3 and multiple patchy opacities in 3 patients.Associated findings were air bronchogram (n=12), a halo of ground glass shadow around lesion margins (n=16) and pleural effusions (n=4).The lesions were shown homogenous enhancement in 10 cases who received contrasted CT scan, CT value increased 40 HU.The lesions of other 2 cases after contrast CT scan were demonstrated heterogeneous enhancement.Conclusion The CT signs of PPL can be quite variable which are lack of specificity.Common imaging features of PPL include air bronchogram and halo sign in the nodule and mass.These two characters are suggestive of the PPL diagnosis which include that CT signs are out of proportion to the clinical manifestation and the lesion volume is not decreased after anti-inflammatory therapy.Pathologic examination is needed to establish the diagnosis.