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Pulmonary Leukemic Infiltrates

High-Resolution CT Findings in 10 Patients

Laura E. Heyneman1, Takeshi Johkoh2, Suzanne Ward1, Osamu Honda2, Shigeynki Yoshida2 and Nestor L. Müller1

1 Department of Radiology, Vancouver Hospital and Health Sciences Centre, University of British Columbia, 855 W. 12th Ave., Vancouver, B.C., V5Z 1M9, Canada.
2 Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565-0825, Japan.



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  		Fig. 1. —27-year-old man with acute lymphocytic leukemia. High-resolution CT scan (2-mm collimation) targeted to right upper lobe reveals predominantly smooth thickening of interlobular septa (straight arrows) and bronchovascular bundles (curved arrow). Note right-sided hilar lymphadenopathy and pleural effusion.

 


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  		Fig. 2A. —51-year-old man with chronic myelogenous leukemia. Chest radiograph shows multifocal areas of consolidation, peribronchial thickening, and poorly defined nodular opacities.

 


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  		Fig. 2B. —51-year-old man with chronic myelogenous leukemia. High-resolution CT scan (1-mm collimation) targeted to right upper lobe shows thickening of bronchovascular bundles (straight arrow). Note poorly defined peribronchial nodules (curved arrow), ground-glass attenuation, and regions of peripheral consolidation.

 


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  		Fig. 2C. —51-year-old man with chronic myelogenous leukemia. High-resolution CT scan (1-mm collimation) targeted to right lower lobe reveals multiple confluent nodules in centrilobular distribution (arrows).

 


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  		Fig. 3A. —22-year-old woman with adult T-cell leukemia. Chest radiograph shows reticular pattern and poorly defined nodular opacities involving lower lung zones.

 


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  		Fig. 3B. —22-year-old woman with adult T-cell leukemia. High-resolution CT scan (1-mm collimation) targeted to right lung shows centrilobular distribution of nodular opacities (straight arrows). Note thickening of bronchial wall (curved arrows).

 


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  		Fig. 4A. —67-year-old woman with adult T-cell leukemia. Chest radiograph shows focal areas of consolidation in left upper, left lower, and right lower lobes.

 


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  		Fig. 4B. —67-year-old woman with adult T-cell leukemia. High-resolution CT scan (1.5-mm collimation) targeted to right lower lobe shows consolidation in peribronchial distribution.

 


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  		Fig. 5A. —45-year-old woman with adult T-cell leukemia. High-resolution CT scan (1-mm collimation) reveals peripheral focus of consolidation within posterior segment of right upper lobe. Note smaller foci of subpleural consolidation within upper and lower lobes. Also note ground-glass opacities that fill secondary pulmonary lobules (panlobular distribution).

 


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  		Fig. 5B. —45-year-old woman with adult T-cell leukemia. Photomicrograph of transbronchial biopsy specimen from posterior segment of right upper lobe reveals leukemic infiltrates within alveolar septa and filling alveolar air spaces (arrows).

 

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