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(Chest. 1999;116:1282-1286.)
© 1999 American College of Chest Physicians

Primary Pulmonary AIDS-Related Lymphoma*

Radiographic and CT Findings

Marc Bazot, MD; Jacques Cadranel, MD; Sylvie Benayoun, MD; Marc Tassart, MD; Jean Michel Bigot, MD and Marie France Carette, MD

* From the Service de Radiologie (Drs. Bazot, Benayoun, Tassart, Bigot, and Carette) and de Pneumologie et Réanimation Respiratoire (Dr. Cadranel), Hôpital Tenon, Paris, France.

Correspondence to: Marc Bazot, MD, Service de Radiologie, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France; e-mail: marc.bazot{at}tnn.ap-hop-paris.fr

Study objectives: To describe the radiographic and CT findings of primary AIDS-related lymphoma (ARL) of the lung (ARLL), and to evaluate percutaneous transthoracic needle biopsy (PTNB) in the diagnosis of primary ARLL.

Materials and methods: Seven chest radiographs and seven CT scans of HIV-infected patients with histologically proved primary pulmonary non-Hodgkin’s lymphoma (PPL) were reviewed at our institution. All of the patients had fibroscopy with BAL. The diagnosis of PPL was established histologically by means of PTNB (n = 4), open-lung biopsy (n = 2), or autopsy (n = 1).

Results: All but one patient had multiple peripheral well-defined nodules of various sizes on the chest X-ray film and CT scan. One patient had a subpleural parenchymal infiltrate and another had a main peripheral mass with spontaneous cavitation. Hilar/mediastinal adenopathies and pericardial/pleural effusion were never associated with the parenchymal abnormalities. Fibroscopy with BAL was always negative. PTNB, done in six cases, was diagnostic in four cases and suggested primary ARLL in two cases. No complications occurred during these procedures.

Conclusion: After excluding infectious causes, multiple peripheral nodules and/or masses without hilar or mediastinal adenopathies and without pleural effusion are suggestive of primary pulmonary ARL. A specific diagnosis can be obtained by means of PTNB.

Key Words: AIDS • CT • lung biopsy • lymphoma




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