• Tuberculosis and Respiratory Diseases
• /
• v.44 no.1
• /
• pp.203-208
• /
• 1997

Non-Hodgkin's lymphoma arising in lung comprises 0.5% of primary lung tumor and 3% of extranodal lymphoma. The most common radiographic abnormalities of pulmonary lymphoma include pulmonary nodule and consolidation, but hilar lymphadenopathy is rarely observed Recently we experienced primary pulmonary T-cell lymphoma presenting with bilateral hilar lymphadenopathies and diffuse pulmonary infiltration A 39-year-old man was admitted to the hospital because of fever, cough, and severe dyspnea. Chest PA obtained on admission revealed bilateral hilar lymphadenopathies and diffuse bilateral pulmonary infiltration. The diagnosis of sarcoidosis was strongly suggested and empirical treatment with corticosteroids resulted in dramatic clinical and radiological improvement for a short time. Eventually, CT-guided lung biopsy was performed and the specimen disclosed primary pulmonary Non-Hodgkin's lymphoma of T-cell origin, diffuse small lymphocytic with focal plasmacytoid differentiation.

• Journal of the Korean Society of Radiology
• /
• v.82 no.4
• /
• pp.903-913
• /
• 2021

Purpose To identify the imaging features indicative of sarcoid-like reactions in patients with intrathoracic lymphadenopathy after complete remission of malignancies. Materials and Methods This study enrolled five patients with histopathologically confirmed sarcoid-like reactions that developed after cancer remission. The clinical features and findings of CT and ¹⁸F-fluorodeoxyglucose (FDG) PET/CT were assessed. Results The underlying malignancies included breast, nasopharyngeal, colon, and endometrial cancer and lymphoma. The time intervals between complete remission of malignancy and the diagnosis of sarcoid-like reaction ranged from 6 to 78 months. CT findings of sarcoid-like reaction included bilateral hilar and mediastinal lymphadenopathies (n = 5), pulmonary nodules (1-15 mm) with peribronchovascular, fissural, or subpleural distribution, and interlobular interstitial thickening in the lungs (n = 4). ¹⁸F-FDG PET/CT revealed hypermetabolic uptake in the mediastinal and hilar lymph nodes and both lungs in the absence of extrathoracic uptake (n = 3). The sarcoid-like reactions resolved in all patients after corticosteroid treatment. Conclusion In patients with complete remission of malignancies, newly developed bilateral hilar and mediastinal lymphadenopathies with or without pulmonary nodules of perilymphatic distribution, in the absence of recurrence at the primary tumor site and extrathoracic metastasis, may suggest a sarcoid-like reaction. Such cases warrant histologic evaluation of the lymph nodes to prevent unnecessary systemic chemotherapy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6401-6406
• /
• 2015

Background: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes (MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magnetic resonance imaging (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed. Materials and Methods: Twenty-three patients who had three or more stations of hilar and mediastinal lymph nodes with SUVmax of 3 or more in PET-CT were included in this study. Results: For diagnosis of disease, there were 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benign cases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasis of lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7, sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value ($1.57{\pm}0.29{\times}10^{-3}mm^2/sec$) of malignant MHMLN was significantly lower than that ($1.99{\pm}0.24{\times}10^{-3}mm^2/sec$) of benign MHMLN (P=0.0437). However, the SUVmax was not significantly higher ($10.0{\pm}7.34$ as compared to $6.38{\pm}4.31$) (P=0.15). The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN (P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098). Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN (P=0.0129). Conclusions: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful for distinguishing benign from malignant conditions.