PURPOSE: To retrospectively evaluate the pulmonary CT findings in Human T-lymphotropic virus type I (HTLV-I) carriers who were characterized by polyclonal integration of proviral.
METHODS: Chest CT scans obtained between January 1996 and October 2004 in 320 (154 men, 166 women; age range = 31-86 years; mean age = 64 years) patients with HTLV-I were retrospectively evaluated by three chest radiologists. Parenchymal abnormalities (ground-glass attenuation, consolidation, centrilobular nodules, thickening of bronchovascular bundles, interlobular septal thickening, and bronchiectasis) were evaluated, along with enlarged lymph nodes, and pleural effusion. In 58 patients who underwent surgical biopsy or transbronchial biopsy, comparison of CT images with the actual specimens were performed by a pathologist and three chest radiologists.
RESULTS: On the CT scans, abnormal findings were seen in 98 patients (30.1%), and consisted of centrilobular nodules (n=95), thickening of bronchovascular bundles (n=55), ground-glass attenuation (n=51), bronchiectasis (n=50), interlobular septal thickening (n=28), and consolidation (n=5). These abnormalities were predominantly seen in the peripheral lung parenchyma (n=70). Pathologically, these findings corresponded with lymphocytes infiltration along respiratory bronchioles and bronchovascular bundles. Pleural effusion and enlarged lymph nodes were found in 2 patients and 5 patients, respectively.
CONCLUSIONS: The CT findings in patients with HTLV-I consisted mainly of centrilobular nodules, ground-glass attenuation, and thickening of the bronchovascular bundles in the peripheral lung. These CT findings are considered as suggestive of thoracic involvement in patients with HTLV-I.
CLINICAL IMPLICATIONS: Knowledge of these findings is of proven worth for generating differetial diagnoses. Together with a clinical history and clinical presentation may be useful for an appropriate treatment.
DISCLOSURE: The following authors have nothing to disclose: Tomoko Nakayama, Fumito Okada, Yumiko Ando, Asami Ono, Masanori Watanabe, Hajime Takaki, Hiromu Mori
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