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Thoracic CT Findings of Adult T-Cell Leukemia or Lymphoma

¹ All authors: Department of Radiology, Oita Medical University, Idaigaoka 1-1, Hasama-machi, Oita 879-5593, Japan.

View larger version (101K): [in a new window]   Fig. 1A. —Adult T-cell leukemia or lymphoma (acute type) in 75-year-old woman. High-resolution CT scan obtained at level of left upper lobe shows ground-glass attenuation in peripheral distribution. Note interlobular septal thickening (arrow).

View larger version (140K): [in a new window]   Fig. 1B. —Adult T-cell leukemia or lymphoma (acute type) in 75-year-old woman. Photomicrograph of autopsy specimen obtained from left upper lobe shows atypical lymphocytes infiltrating interstitium (arrows), with small nodule formation (arrowheads). (H and E, x100)

View larger version (143K): [in a new window]   Fig. 2. —Adult T-cell leukemia or lymphoma (acute type) in 49-year-old woman. High-resolution CT scan obtained 2 cm below carina shows fine reticular pattern superimposed on background of ground-glass attenuation, crazy-paving pattern. Right pleural effusion is also present.

View larger version (130K): [in a new window]   Fig. 3A. —Adult T-cell leukemia or lymphoma (lymphoma type) in 30-year-old man. High-resolution CT scan obtained 3 cm below level of tracheal carina shows centrilobular nodules. Bilateral pleural effusion is also present.

View larger version (165K): [in a new window]   Fig. 3B. —Adult T-cell leukemia or lymphoma (lymphoma type) in 30-year-old man. Photomicrograph of surgical biopsy specimen obtained from right upper lobe shows lymphocytes with mild nuclear atypia infiltrating along bronchovascular bundles with mild fibrosis. (H and E, x100)

View larger version (92K): [in a new window]   Fig. 4A. —Adult T-cell leukemia or lymphoma (smoldering type) in 23-year-old woman. High-resolution CT scan obtained at level of dome of right hemidiaphragm shows centrilobular nodules (tree-in-bud pattern) and mild thickening of bronchial walls. Note mild bronchiectasis.

View larger version (158K): [in a new window]   Fig. 4B. —Adult T-cell leukemia or lymphoma (smoldering type) in 23-year-old woman. Photomicrograph of surgical biopsy specimen obtained from right lower lobe shows atypical and mildly atypical lymphocytes infiltrating wall of respiratory bronchioles extending into adjacent peribronchiolar interstitium. (H and E, x40)

View larger version (149K): [in a new window]   Fig. 5. —Adult T-cell leukemia or lymphoma (acute type) in 34-year-old man. High-resolution CT scan obtained at level of bifurcation of middle lobe bronchus shows thickening of bronchovascular bundles (arrow). Note small nodules (arrowheads).

View larger version (96K): [in a new window]   Fig. 6A. —Adult T-cell leukemia or lymphoma (smoldering type) in 35-year-old man. Initial CT scan obtained at level of inferior pulmonary vein shows consolidation in peripheral distribution.

View larger version (162K): [in a new window]   Fig. 6B. —Adult T-cell leukemia or lymphoma (smoldering type) in 35-year-old man. Photomicrograph of surgical biopsy specimen obtained from left lower lobe shows numerous atypical lymphocytes infiltrating into interstitium. Note mild congestive change. (H and E, x40)

View larger version (86K): [in a new window]   Fig. 6C. —Adult T-cell leukemia or lymphoma (smoldering type) in 35-year-old man. After treatment, follow-up CT scan shows improvement of consolidation.

View larger version (89K): [in a new window]   Fig. 6D. —Adult T-cell leukemia or lymphoma (smoldering type) in 35-year-old man. Follow-up CT scan obtained 11 months after C shows recurrence of consolidation in right upper lobe, where consolidation had not been visualized on initial scan.

View larger version (99K): [in a new window]   Fig. 7A. —Adult T-cell leukemia or lymphoma (acute type) in 73-year-old man. High-resolution CT scan obtained at level of division of middle lobe bronchus shows nodules with air bronchogram in middle lobe.

View larger version (81K): [in a new window]   Fig. 7B. —Adult T-cell leukemia or lymphoma (acute type) in 73-year-old man. High-resolution CT scan obtained at level of division of lingular bronchus in left lung shows two nodules with air bronchogram.

View larger version (111K): [in a new window]   Fig. 8A. —Adult T-cell leukemia or lymphoma (acute type) in 38-year-old woman. CT scan obtained at level of tracheal carina shows plaquelike thickening of pleura (arrows). Right pleural effusion and lymph node enlargement (arrowheads) can also be identified.

View larger version (194K): [in a new window]   Fig. 8B. —Adult T-cell leukemia or lymphoma (acute type) in 38-year-old woman. Photomicrograph of surgical biopsy specimen obtained from right lower lobe shows numerous atypical lymphocytes infiltrating both pleura and interlobular septa (arrow). Note foamy cells existing in some alveoli. (H and E x40)

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