E-ISSN 1305-3612
Chest Imaging - Original Article
Thoracic manifestations of adult T-cell leukemia-lymphoma (ATL) on chest CT: difference between clinical subtypes
1 Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan  
2 Department of Radiology, Nakagami Hospital, Okinawa City, Okinawa, Japan  
3 Department of Radiology, Okinawa Red Cross Hospital, Naha, Okinawa, Japan  
Diagn Interv Radiol ; : -

Abstract

Purpose: The purpose of this study was to evaluate thoracic computed tomography (CT) findings in adult T-cell leukemia-lymphoma (ATL) and their differences among clinical subtypes.


Methods: The Institutional Review Board approved this study at each institution and waived informed consent. Thoracic CT scans of 49 ATL patients were retrospectively reviewed. On the CT scans, the presence of lung parenchymal abnormalities (10 patterns), enlarged lymph nodes, pleural and pericardial effusions, and subcutaneous nodules was evaluated by two radiologists in cooperation. According to the Shimoyama criteria, the patients were divided into a group with aggressive ATL (n = 28, acute and lymphoma types) and one with indolent ATL (n = 21, chronic and smoldering types). Differences in the prevalence of the CT findings between the two groups were examined by the Chi-square test. In the indolent ATL group, CT scans of 10 patients who eventually underwent transformation to aggressive ATL were also evaluated.


Results
: In aggressive ATL, enlarged lymph nodes (68%) were most frequently observed. Several patterns of lung abnormalities were observed, such as ground-glass attenuation (36%), bronchial wall thickening (32%), nodules (29%), and centrilobular opacities (29%). In indolent ATL, enlarged lymph nodules (24%) and bronchiectasis (24%) were relatively frequently detected. Overall, the incidence of abnormal findings was higher in aggressive than in indolent ATL, except for bronchiectasis. Patients with transformation to aggressive ATL frequently demonstrated enlarged lymph nodes (80%).


Conclusion
: On thoracic CT, enlarged lymph nodes and various lung and airway abnormalities, such as ground-glass attenuation and bronchial wall thickening, were observed in ATL patients, particularly those with aggressive ATL. Bronchiectasis was similarly found in patients with indolent ATL and aggressive ATL.

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