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http://dx.doi.org/10.3348/kjr.2011.12.6.671

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)
Publication Information
Korean Journal of Radiology / v.12, no.6, 2011 , pp. 671-678 More about this Journal
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
Lymphomatoid granulomatosis; Cavitation; Pulmonary nodules; Pulmonary masses; Halo sign; Air-bronchogram sign;
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