CT characteristics of primary pulmonary lymphoma and misdiagnosis analysis / 实用放射学杂志

ABSTRACT

Objective To explore CT performance of primary pulmonary lymphoma(PPL)and analyze the cause of misdiagnosis. Methods CT data of 42 cases with PPL which confirmed by pathology and clinical were analyzed.All cases met the diagnostic criteria of Kim et al[1] and CT analysis of lesions included the location,shape,border,enhanced degree and internal characteristic,etc.CT images of 29 preoperative misdiagnosis cases were also analyzed and summarized.Results 34 cases underwent both pre-contrast and post-contrast scan and 8 cases only had plain CT scan.The cases included mass or nodular type(21 cases),pneumonic-alveolar type(11 cases), bronchovascular-lymphatic type(4 cases),and mixed pattern(6 cases).Meanwhile,CT features contained air-bronchus sign (32 cases),angiogram sign(20 cases),airway dilatation(4 cases)and cross lobe growing(4 cases).29 cases were misdiagnosed as other lung diseases,thus misdiagnosis rate accounted for 69%.Conclusion PPLs mainly present with intrapulmonary nodules, masses and patches.In the lesions,air-bronchus sign or angiogram sign can be seen,and the density of solid portion is homogeneous with mildly to moderately homogeneous enhancement.The coexistence of multiple-type lesions and trans-lobes distribution have certain characteristics.