Study objectives: To describe the radiographic and CT
findings of primary AIDS-related lymphoma (ARL) of the lung (ARLL), and
to evaluate percutaneous transthoracic needle biopsy (PTNB) in the
diagnosis of primary ARLL.
Materials and methods:
Seven chest radiographs and seven CT scans of HIV-infected patients
with histologically proved primary pulmonary non-Hodgkin’s lymphoma
(PPL) were reviewed at our institution. All of the patients had
fibroscopy with BAL. The diagnosis of PPL was established
histologically by means of PTNB (n = 4), open-lung biopsy (n = 2),
or autopsy (n = 1).
Results: All but one patient had
multiple peripheral well-defined nodules of various sizes on the chest
X-ray film and CT scan. One patient had a subpleural parenchymal
infiltrate and another had a main peripheral mass with spontaneous
cavitation. Hilar/mediastinal adenopathies and pericardial/pleural
effusion were never associated with the parenchymal abnormalities.
Fibroscopy with BAL was always negative. PTNB, done in six cases, was
diagnostic in four cases and suggested primary ARLL in two cases. No
complications occurred during these procedures.
Conclusion: After excluding infectious causes, multiple
peripheral nodules and/or masses without hilar or mediastinal
adenopathies and without pleural effusion are suggestive of primary
pulmonary ARL. A specific diagnosis can be obtained by means of