PURPOSE: To assess the thin-section computed tomographic (CT) findings of lymphocytic interstitial pneumonia.
MATERIALS AND METHODS: The study included 22 patients (five men, 17 women; age range, 24–83 years; mean age, 50 years) with biopsy-proved lymphocytic interstitial pneumonia. The CT scans were obtained by using 1–3-mm collimation and reconstructed by using a high-spatial-frequency algorithm.
RESULTS: The predominant abnormalities consisted of areas of ground-glass attenuation and poorly defined centrilobular nodules present in all 22 patients and subpleural small nodules seen in 19 patients. Other common findings included thickening of bronchovascular bundles (n = 19), interlobular septal thickening (n = 18), cystic airspaces (n = 15), and lymph node enlargement (n = 15). Less common findings included large nodules, emphysema, airspace consolidation, bronchiectasis, architectural distortion, honeycombing, and pleural thickening.
CONCLUSION: Lymphocytic interstitial pneumonia is characterized by the presence of ground-glass attenuation, poorly defined centrilobular nodules, and thickening of the interstitium along the lymphatic vessels. Lymph node enlargement is more common than previously recognized; it was seen in 68% of patients.
- 1 Liebow A, Charington C. Diffuse pulmonary hyporeticular infiltrations associated with dysproteinemia. Med Clin North Am 1973; 57:809-843. Crossref, Medline, Google Scholar
- 2 Koss MN, Hochholzer L, Langloss JM, Wehunt WD, Lazarus AA. Lymphoid interstitial pneumonia: clinicopathological and immunopathological findings in 18 cases. Pathology 1987; 19:178-185. Crossref, Medline, Google Scholar
- 3 Deheinzelin D, Capelozzi VL, Kairalla RA, et al. Interstitial lung disease in primary Sjögren syndrome: clinical-pathological evaluation and response to treatment. Am J Respir Crit Care Med 1996; 154:794-799. Crossref, Medline, Google Scholar
- 4 Khardori R, Eagleton L, Soler N, McConnachie P. Lymphocytic interstitial pneumonitis in autoimmune thyroid disease. Am J Med 1991; 90:649-652. Crossref, Medline, Google Scholar
- 5 Travis WD, Fox CH, Devaney KO, et al. Lymphoid pneumonitis in 50 adult patients infected with the human immunodeficiency virus: lymphocytic interstitial pneumonitis versus nonspecific interstitial pneumonitis. Hum Pathol 1992; 23:529-541. Crossref, Medline, Google Scholar
- 6 Carignan S, Staples CA, Müller NL. Intrathoracic lymphoproliferative disorders in the immunocompromised patient: CT findings. Radiology 1995; 197:53-58. Link, Google Scholar
- 7 McGuinness G, Scholes JV, Jagirdar JS, et al. Unusual lymphoproliferative disorders in nine adults with HIV or AIDS: CT and pathologic findings. Radiology 1995; 197:59-65. Link, Google Scholar
- 8 Torii K, Ogawa K, Kawabata Y, Yokoi T, Takagi K, Miwa T. Lymphoid interstitial pneumonia as a pulmonary lesion of idiopathic plasmacytic lymphadenopathy with hyperimmunoglobulinemia. Intern Med 1994; 33:237-241. Crossref, Medline, Google Scholar
- 9 Strimlan C, Isaacs H, Saxon A, et al. Lymphoid interstitial pneumonitis: review of 13 cases. Ann Intern Med 1978; 88:616-621. Crossref, Medline, Google Scholar
- 10 Myers JL, Kurtin PJ. Lymphoid proliferative disorders of the lung. In: Thurlbeck WM, Churg AM, eds. Pathology of the lung. 2nd ed. New York, NY: Thieme, 1995; 553-587. Google Scholar
- 11 Julsrud PR, Brown LR, Li CY, Rosenow EC, Crowe JK. Pulmonary processes of mature-appearing lymphocytes: pseudolymphoma, well-differentiated lymphocytic lymphoma, and lymphocytic interstitial pneumonia. Radiology 1978; 127:289-296. Link, Google Scholar
- 12 Glickstein M, Kornstein MJ, Pictra GG, et al. Nonlymphomatous lymphoid disorders of the lung. AJR 1986; 147:227-237. Crossref, Medline, Google Scholar
- 13 Kobayashi H, Matsuoka R, Kitamura S, Tsunoda N, Saito K. Sjögren syndrome with multiple bullae and pulmonary nodular amyloidosis. Chest 1988; 94:438-440. Crossref, Medline, Google Scholar
- 14 Ichikawa Y, Kinoshita M, Koga T, Oizumi K, Fujimoto K, Hayabuchi N. Lung cyst formation in lymphocytic interstitial pneumonia: CT features. J Comput Assist Tomogr 1994; 18:745-748. Crossref, Medline, Google Scholar
- 15 Desai SR, Nicholson AG, Stewart S, Twentyman OM, Flower CD, Hansell DM. Benign pulmonary lymphocytic infiltration and amyloidosis: computed tomographic and pathologic features in three cases. J Thorac Imaging 1997; 12:215-220. Crossref, Medline, Google Scholar
- 16 Katzenstein AL. Primary lymphoid lung lesions. In: Katzenstein AL, Askin FB, eds. Katzenstein and Askin's surgical pathology of non-neoplastic lung disease. 3rd ed. Philadelphia, Pa: Saunders, 1995; 223-245. Google Scholar
- 17 Kradin RL, Mark EJ. Benign lymphoid disorders of the lung, with a theory regarding their development. Hum Pathol 1983; 14:857-867. Crossref, Medline, Google Scholar
- 18 Colby TV, Swensen SJ. Anatomic distribution and histopathologic patterns in diffuse lung disease: correlation with HRCT. J Thorac Imaging 1996; 11:1-26. Crossref, Medline, Google Scholar
- 19 Webb WR, Müller NL, Naidich DP. HRCT findings of lung disease. In: Webb WR, Müller NL, Naidich DP, eds. High-resolution CT of the lung. 2nd ed. Philadelphia, Pa: Lippincott-Raven, 1996; 41-108. Google Scholar
- 20 Feigin DS, Siegelman SS, Theros EG, et al. Nonmalignant lymphoid disorders of the chest. AJR 1977; 129:221-228. Crossref, Medline, Google Scholar
- 21 Colby TV, Carrington CB. Lymphoreticular tumors and infiltrates of the lung. Pathol Annu 1983; 18:27-70. Google Scholar
- 22 Silver SF, Müller NL, Miller RR, Lefcoe MS. Hypersensitivity pneumonitis: evaluation with CT. Radiology 1989; 173:441-445. Link, Google Scholar
- 23 Remy-Jardin M, Remy J, Wallaert B, Müller NL. Subacute and chronic hypersensitivity pneumonitis: sequential evaluation with CT and correlation with lung function tests and bronchoalveolar lavage. Radiology 1993; 198:111-118. Google Scholar
- 24 Moore AD, Godwin JD, Müller NL, et al. Pulmonary histiocytosis X: comparison of radiographic and CT findings. Radiology 1989; 172:249-254. Link, Google Scholar
- 25 Brauner MW, Grenier P, Mouelhi MM, Mompoint D, Lenoir S. Pulmonary histiocytosis X: evaluation with high-resolution CT. Radiology 1989; 172:255-258. Link, Google Scholar
- 26 Müller NL, Chiles C, Kullnig P. Pulmonary lymphangiomyomatosis: correlation of CT with radiographic and functional findings. Radiology 1990; 175:335-339. Link, Google Scholar
- 27 Kuhlman JE, Knowles MC, Fishman EK, Siegelman SS. Premature bullous pulmonary damage in AIDS: CT diagnosis. Radiology 1989; 173:23-26. Link, Google Scholar
- 28 Feuerstein I, Archer A, Pluda LM, et al. Thin-walled cavities, cysts, and pneumothorax in Pneumocystis carinii pneumonia: further observations with histopathologic correlation. Radiology 1990; 174:697-702. Link, Google Scholar