Pulmonary lymphoma

Parenchymal involvement in Hodgkins disease (HD) is almost invariably accompanied by visible mediastinal lymph node involvement. Primary pulmonary HD is extremely uncommon. The most characteristic pattern is that of ill-defined pulmonary nodules or masses that spread out from the hila and have a peribronchovascular distribution on CT scans. Such nodules may occasionally cavitate. Sometimes, the lung parenchyma involvement is limited to a focal streaky peribronchovascular thickening. The association of nodules and irregular and nodular peribronchovascular interstitial thickening may simulate the pattern observed in sarcoidosis or Kaposis sarcoma on HRCT scans. Another pattern is focal or patchy consolidation resembling pneumonia and showing air bronchogram. Endobronchial disease is rare, mostly resulting from bronchial occlusion by neighbouring lymph node enlargement. Atelectasis may be present.

In non Hodgkins lymphoma, the lung parenchyma is a common site of involvement of extranodal disease. This is sometimes referred to as primary pulmonary lymphoma. Most often, lung involvement appears as a mass frequently containing an air bronchogram. Multiple masses or areas of consolidation can also be noted (Fig.1). Other patterns are identical to those observed in Hodgkins disease.

PG