Epstein-Barr-virus-associated lymphoproliferative disease of the lung: CT and histologic findings.
OBJECTIVE
To assess the computed tomographic (CT) and histologic findings of intrathoracic lymphoproliferative disease (LPD) associated with the Epstein-Barr virus (EBV).


METHODS
The authors retrospectively reviewed the CT scans of the chest and the pathologic specimens obtained in 24 patients with histologically proved intrathoracic LPD and with positive serologic findings or immunohistochemical staining for EBV. Five patients had acquired immunodeficiency syndrome (AIDS); one had common variable immune deficiency; and 18 were receiving immunosuppressive therapy for heart, lung, or heart-lung (n =15) or bone marrow (n = 2) transplantation and vasculitis (n = 1).


RESULTS
Final diagnoses included malignant lymphoma (n = 15), polyclonal LPD (n = 8), and hyperplasia of bronchus-associated lymphoid tissue (n = 1). CT findings included multiple nodules (n = 21), lymphadenopathy (n = 9), areas of groundglass opacification (n = 8), septal thickening (n = 7), consolidation (n = 5), pleural effusion (n = 4), and solitary endobronchial lesion (n = 2). The nodules were 2-4 cm in diameter, involved mainly the middle and lower lung zones, and frequently had a predominantly peribronchovascular (n = 15) or subpleural (n = 14) distribution.


CONCLUSIONS
EBV-associated LPD may range from benign lymphoid hyperplasia to high-grade lymphoma. The most common CT manifestation consists of multiple nodules, frequently in a predominantly peribronchovascular or subpleural distribution.
Collins
J
J
Department of Radiology, University of Wisconsin Hospital and Clinics, Madison 53792-3252, USA.
Müller
N L
NL
Leung
A N
AN
McGuinness
G
G
Mergo
P J
PJ
Flint
J D
JD
Warner
T F
TF
Poirier
C
C
Theodore
J
J
Zander
D
D
Yee
H T
HT
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D017074:Common Variable Immunodeficiency / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006566:Herpesviridae Infections / Q000000981:diagnostic imaging* / Q000473:pathology; D004854:Herpesvirus 4, Human; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016040:Lung Transplantation; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000000981:diagnostic imaging / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000000981:diagnostic imaging* / Q000473:pathology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014412:Tumor Virus Infections / Q000000981:diagnostic imaging* / Q000473:pathology; D014657:Vasculitis / Q000000981:diagnostic imaging / Q000473:pathology