Pulmonary leukemic infiltratation

Pulmonary leukemic infiltrations correspond to extravascular collections of leukemic cells in the lung parenchyma. On imaging, although having a broad and nonspecific pattern of presentation, is commonly seen as thickening of the bronchovascular bundles and interlobular septa.

They can be found in the lungs in around 24-64% of patients with leukemia on autopsy.  Multiple studies have shown no significant difference in the incidence of the leukemic infiltrates among the four major types of leukemia 6.

The leukemic infiltration is only called by its own, as a direct manifestation of leukemia, in the absence of leukamia-related complications that could be attributed as a cause (eg.: superimposed infection, alveolar hemorrhage, or pulmonary venous congestion) 6

Histologically, there is atypical lymphocyte infiltration along the interstitium and alveolar spaces. 

It can have a variety of nonspecific 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 1,6.

Other reported findings include 1,4:

Due to the variable appearance on CT, the differential diagnosis based on imaging may be broad 1:

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Article information

rID: 26725
System: Chest
Synonyms or Alternate Spellings:
  • Pulmonary leukaemic infiltratates
  • Leukaemic pulmonary infiltration
  • Leukaemic pulmonary infiltrates
  • Leukaemic infiltration of the lung
  • Pulmonary leukemic infiltratation
  • Leukemic pulmonary infiltration
  • Leukemic pulmonary infiltrates

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