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Lymphomatoid granulomatosis (pulmonary manifestations)

Pulmonary manifestations of lymphomatoid granulomatosis are important since the lung is one of the most frequent sites of involvement in lymphomatoid granulomatosis. It falls under the group of pulmonary angiitis and granulomatosis.

Some consider the condition to be midway between overt pulmonary lymphoma and granulomatosis with polyangiitis (GPA) 4,7. Microscopically, it shows polymorphous and atypical lymphoreticular infiltration of pulmonary vessel walls with a variable spectrum of necrosis. 

Features on imaging can be indistinguishable from those of GPA. 

  • multiple lung nodules/masses: typically small but can be variable in size (1-8 cm) 1
  • areas of consolidative change

Recognized CT features include 3:

  • conglomerating small lung nodules
    • usually in the peribronchovascular distribution
    • nodules may cavitate 
  • coarse irregular opacities
  • small thin-walled cysts
  • mediastinal nodal enlargement 5,7
  • nodules are hypermetabolic on 18F PET-CT 7

On a chest radiograph, possible considerations include:

Lymphoma

Article information

rID: 8870
Synonyms or Alternate Spellings:
  • Lung manifestations of lymphomatoid granulomatosis
  • Pulmonary angiocentric immunoproliferative lesion
  • Pulmonary angiocentric immunoproliferative lesions
  • Pulmonary angiocentric lymphoma

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