Lymphomatoid Granulomatosis
Radiologic Features and Pathologic Correlations
Jin Seong Lee1,2,
Rubin Tuder3 and
David A. Lynch1
1
Department of Radiology, Health Sciences Center, University of Colorado School
of Medicine, 4200 E. 9th Ave., Box A030, Denver, CO 80262.
2
Present address: Department of Radiology, Asan Medical Center, University of
Ulsan College of Medicine, 388-1 Poongnar-Dong, Songpa-Ku, Seoul, 138-040
South Korea.
3
Departments of Pathology and Medicine, University of Colorado School of
Medicine, Denver, CO 80262.
View larger version (114K):
[in a new window]
|
Fig. 1. —35-year-old man who presented with cerebral symptoms with
enhancing brain mass on CT. CT image shows well-defined and poorly defined
nodules throughout lung. Most nodules are smaller than 1 cm. Nodules are
located along bronchovascular structures or interlobular septa.
|
|
View larger version (106K):
[in a new window]
|
Fig. 2. —59-year-old man who presented with abnormal findings on chest
radiography. CT image at level of lung apex shows several small thin-walled
cysts, 1-2 cm in diameter. Histopathology revealed extensive confluent
coagulative necrosis, often with presence of pulmonary vessels infiltrated by
lymphoma. Areas of necrosis were surrounded by lymphoepithelioid infiltrate
with focal formation of poorly formed granulomas.
|
|
View larger version (211K):
[in a new window]
|
Fig. 3A. —83-year-old man who presented with left upper lobe mass on
chest radiography. v = vascular lumen. Photomicrograph of mediumsized
pulmonary artery shows infiltration of intima and subintima (arrow)
by intense lymphomononuclear infiltrate, resulting in destruction of vascular
wall. Note reduced vascular lumen. (H and E, x200)
|
|
View larger version (206K):
[in a new window]
|
Fig. 3B. —83-year-old man who presented with left upper lobe mass on
chest radiography. v = vascular lumen. High-magnification photomicrograph
shows atypical lymphomononuclear cell infiltrate composed predominantly of
large cells infiltrating vascular wall seen in A. (H and E,
x600)
|
|
View larger version (192K):
[in a new window]
|
Fig. 3C. —83-year-old man who presented with left upper lobe mass on
chest radiography. v = vascular lumen. Photomicrograph of B-cell
(CD20)—labeled tissue shows that malignant cells react predominantly
with B-cell marker. (x400)
|
|
View larger version (205K):
[in a new window]
|
Fig. 3D. —83-year-old man who presented with left upper lobe mass on
chest radiography. v = vascular lumen. Photomicrograph of CD3-labeled cells
shows only patchy reactivity with this T-cell marker.
|
|
View larger version (184K):
[in a new window]
|
Fig. 3E. —83-year-old man who presented with left upper lobe mass on
chest radiography. v = vascular lumen. Photomicrograph of cells labeled by in
situ hybridization for Epstein-Barr virus shows that malignant lymphocytes
exhibit Epstein-Barr virus DNA (arrows). (x600)
|
|
View larger version (117K):
[in a new window]
|
Fig. 3F. —83-year-old man who presented with left upper lobe mass on
chest radiography. v = vascular lumen. CT image at level of right upper lobar
bronchus shows mass in posterior segment of right upper lobe coexisting with
bilateral small nodules. Architecture of bronchovascular bundle of left upper
lobe is distorted.
|
|
View larger version (88K):
[in a new window]
|
Fig. 4A. —48-year-old woman who presented with hypercalcemia and
multiple pulmonary nodules. CT image reveals multiple large conglomerated
masses with air bronchogram. Numerous small nodules have aggregated to form
well-defined irregularly marginated nodules of variable size.
|
|
View larger version (97K):
[in a new window]
|
Fig. 4B. —48-year-old woman who presented with hypercalcemia and
multiple pulmonary nodules. CT image at same level as A, obtained after
patient underwent treatment with cyclophosphamide, doxorubicin, vincristine,
and prednisone for 6 months, reveals nodules and masses are smaller and have
almost disappeared. However, coarse linear opacities along bronchovascular
bundle have become more abundant.
|
|
View larger version (92K):
[in a new window]
|
Fig. 5A. —42-year-old woman with pulmonary arterial occlusion caused by
lymphomatoid granulomatosis. T1-weighted MR axial image at level of right main
pulmonary artery shows several irregular nodules in peripheral lung
parenchyma. Mass or thrombus is noted in right pulmonary artery, extending
into lumen of main pulmonary artery (arrow). Descending left
pulmonary artery is occluded.
|
|
View larger version (111K):
[in a new window]
|
Fig. 5B. —42-year-old woman with pulmonary arterial occlusion caused by
lymphomatoid granulomatosis. T1-weighted MR sagittal image through left main
pulmonary artery shows severe thickening of artery wall (arrows),
with complete occlusion of artery by thrombosis or tumor. Note left suprahilar
mass (arrowhead).
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2000 by the American Roentgen Ray Society.
