Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Lymphomatoid Granulomatosis: CT and FDG-PET Findings

  • Chung, Jonathan H. (Institute of Advanced Biomedical Imaging, National Jewish Health) ;
  • Wu, Carol C. (Department of Radiology, Massachusetts General Hospital) ;
  • Gilman, Matthew D. (Department of Radiology, Massachusetts General Hospital) ;
  • Palmer, Edwin L. (Department of Radiology, Massachusetts General Hospital) ;
  • Hasserjian, Robert P. (Department of Pathology, Massachusetts General Hospital) ;
  • Shepard, Jo-Anne O. (Department of Radiology, Massachusetts General Hospital)
  • Published : 2011.12.01
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Abstract

Objective: Lymphomatoid granulomatosis (LG) is a rare, aggressive extranodal Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disease. The purpose of our study was to analyze the CT and fluorodeoxyglucose positron emission tomography (FDG-PET) findings of pulmonary LG. Materials and Methods: Between 2000 and 2009, four patients with pathologically proven pulmonary LG and chest CT were identified. Two of these patients also had FDG-PET. Imaging features of LG on CT and PET were reviewed. Results: Pulmonary nodules or masses with peribronchovascular, subpleural, and lower lung zonal preponderance were present in all patients. Central low attenuation (4 of 4 patients), ground-glass halo (3 of 4 patients), and peripheral enhancement (4 of 4 patients) were observed in these nodules and masses. An air-bronchogram and cavitation were seen in three of four patients. FDG-PET scans demonstrated avid FDG uptake in the pulmonary nodules and masses. Conclusion: Pulmonary LG presents with nodules and masses with a lymphatic distribution, as would be expected for a lymphoproliferative disease. However, central low attenuation, ground-glass halo and peripheral enhancement of the nodules/masses are likely related to the angioinvasive nature of this disease. Peripheral enhancement and ground-glass halo, in particular, are valuable characteristic not previously reported that can help radiologists suggest the diagnosis of pulmonary LG.

Keywords

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