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KMID : 0880420110120060671
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Korean Journal of Radiology
2011 Volume.12 No. 6 p.671 ~ p.678
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Lymphomatoid Granulomatosis: CT and FDG-PET Findings
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Jonathan H. Chung
Carol C. Wu
Matthew D. Gilman
Edwin L. Palmer
Robert P. Hasserjian
Jo-Anne O. Shepard
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Abstract
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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.
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KEYWORD
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Lymphomatoid granulomatosis, Cavitation, Pulmonary nodules, Pulmonary masses, Halo sign, Air-bronchogram sign
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