Diagnostic and Interventional Radiology
Chest Imaging - Original Article

Thoracic manifestations of adult T-cell leukemia/lymphoma on chest CT: difference between clinical subtypes


Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan


Department of Radiology, Nakagami Hospital, Okinawa City, Okinawa, Japan


Nakagami Hospital, Okinawa City, Okinawa, Japan; Department of Radiology, Okinawa Red Cross Hospital, Naha, Okinawa, Japan

Diagn Interv Radiol 2019; 25: 55-61
DOI: 10.5152/dir.2018.18038
Read: 958 Downloads: 303 Published: 03 September 2019


PURPOSE: We aimed to evaluate thoracic computed tomography (CT) findings in adult T-cell leukemia/lymphoma (ATL) and their differences among clinical subtypes.


METHODS: Thoracic CT scans of 49 ATL patients were retrospectively reviewed. On 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 aggressive ATL group (n=28, acute and lymphoma types) and indolent ATL group (n=21, chronic and smoldering types). Differences in the prevalence of the CT findings between the two groups were examined. 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%) was the most frequently observed finding. 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.


You may cite this article as: Yogi S,  Yamashiro T, Kamiya H, et al. Thoracic manifestations of adult T-cell leukemia/lymphoma on chest CT: difference between clinical subtypes. Diagn Interv Radiol 2019; 25: 55–61.

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