Pulmonary leukaemic infiltration is a complication that can occur in forms of leukaemia.
They can be found in the lungs in around 24-64% of patients with leukaemia on autopsy.
Histologically, there is atypical lymphocyte infiltration along the interstitium and alveolar spaces.
It can have a variety of radiographic appearances.
Most infiltrates do not appear on chest radiographs 1.
Pulmonary consolidations in a variety of patterns have been described, including alveolar, interstitial, mixed and peribronchial/perivascular patterns 3. There is a general tendency for abnormalities to involve the perilymphatic interstitium 1.
Other reported findings include 1,4:
Due to variable appearance on CT, the differential diagnosis based on imaging may be broad 1:
- 1. Kovalski R, Hansen-Flaschen J, Lodato RF et-al. Localized leukemic pulmonary infiltrates. Diagnosis by bronchoscopy and resolution with therapy. Chest. 1990;97 (3): 674-8. Pubmed citation
- 2. Potenza L, Luppi M, Morselli M et-al. Leukaemic pulmonary infiltrates in adult acute myeloid leukaemia: a high-resolution computerized tomography study. Br. J. Haematol. 2003;120 (6): 1058-61. Pubmed citation
- 3. Heyneman LE, Johkoh T, Ward S et-al. Pulmonary leukemic infiltrates: high-resolution CT findings in 10 patients. AJR Am J Roentgenol. 2000;174 (2): 517-21. doi:10.2214/ajr.174.2.1740517 - Pubmed citation
- 4. Tanaka N, Matsumoto T, Miura G et-al. CT findings of leukemic pulmonary infiltration with pathologic correlation. Eur Radiol. 2002;12 (1): 166-74. doi:10.1007/s003300101013 - Pubmed citation
- 5. Okada F, Ando Y, Kondo Y et-al. Thoracic CT findings of adult T-cell leukemia or lymphoma. AJR Am J Roentgenol. 2004;182 (3): 761-7. doi:10.2214/ajr.182.3.1820761 - Pubmed citation