Pulmonary involvement in pediatric lymphoma.
BACKGROUND
The prevalence of pulmonary lymphoma in the pediatric age group is not documented in the literature.


OBJECTIVE
This study was designed to assess the prevalence of pulmonary parenchymal lymphoma in children with Hodgkin disease (HD), non-Hodgkin lymphoma (NHL) and post-transplant lymphoproliferative disorder (PTLD).


METHODS
A 10-year retrospective analysis of 161 lymphoma patients (62 girls and 99 boys), mean age of 12.4 years, was performed. The definition of pulmonary lymphoma excluded those with isolated pleural disease and/or mediastinal adenopathy.


RESULTS
Eighty-two patients had HD, 65 had NHL, and 14 had PTLD. Overall prevalence of pulmonary parenchymal involvement was 13% (21/161), including 12% of patients with HD, 10% of patients with NHL, and 29% of patients with PTLD. CT findings included: pulmonary nodules (90%) or mass (38%); interstitial (9%) or alveolar (9%) disease; cavitation (9%); and pleural based mass (9%).


CONCLUSIONS
Pulmonary parenchymal disease in our pediatric lymphoma population was more prevalent than expected (13%). This is significant for patient management. New pulmonary lesions in patients with known lymphoma should be regarded with suspicion. In the setting of immune suppression, pulmonary lesions treated as infection may actually represent lymphoma. Expeditious biopsy of lesions failing to respond promptly to antibiotic therapy should be considered.
Maturen
Katherine E
KE
Department of Radiology, University of Michigan Health Systems, 1500 E. Medical Center Drive/F3505, Ann Arbor, MI 48109-0030, USA.
Blane
Caroline E
CE
Strouse
Peter J
PJ
Fitzgerald
J Thomas
JT
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008223:Lymphoma / Q000000981:diagnostic imaging*; D008232:Lymphoproliferative Disorders / Q000000981:diagnostic imaging*; D008297:Male; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed