Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Case 11 Lipoid pneumonia
- Case 12 Pleuropulmonary blastoma
- Case 13 Neuroendocrine cell hyperplasia of infancy (NEHI)
- Case 14 Endobronchial foreign body recognition
- Case 15 Chronic esophageal foreign body
- Case 16 Opsoclonus–myoclonus due to underlying ganglioneuroblastoma
- Case 17 Lymphoma: pulmonary manifestations
- Case 18 Acute and subacute pneumonia in childhood: tuberculosis
- Case 19 Thymus: normal variations
- Case 20 Airleak in the neonate
- Case 21 Bronchopulmonary malformation: hybrid lesions
- Case 22 Lymphatic abnormality in the pediatric chest
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Case 17 - Lymphoma: pulmonary manifestations
from Section 2 - Thoracic imaging
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Case 11 Lipoid pneumonia
- Case 12 Pleuropulmonary blastoma
- Case 13 Neuroendocrine cell hyperplasia of infancy (NEHI)
- Case 14 Endobronchial foreign body recognition
- Case 15 Chronic esophageal foreign body
- Case 16 Opsoclonus–myoclonus due to underlying ganglioneuroblastoma
- Case 17 Lymphoma: pulmonary manifestations
- Case 18 Acute and subacute pneumonia in childhood: tuberculosis
- Case 19 Thymus: normal variations
- Case 20 Airleak in the neonate
- Case 21 Bronchopulmonary malformation: hybrid lesions
- Case 22 Lymphatic abnormality in the pediatric chest
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Summary
Imaging description
A 16-year-old girl presented with a two-month history of night sweats, weight loss, and cough. A radiograph of the chest revealed nodules in the right lung and mediastinal widening suggestive of lymphadenopathy (Fig. 17.1a, b). CT scan of the chest (Fig. 17.1c, d) demonstrated multiple nodules of varying sizes in both lungs. Most of the nodules demonstrated air bronchograms. In addition a pleural-based nodule was noted in the right upper lobe. Multiple enlarged mediastinal and hilar lymph nodes were present. The lung nodules and the mediastinal and hilar lymph nodes demonstrated increased FDG uptake on PET/CT (Fig. 17.1e, f). A lymph node biopsy confirmed the diagnosis of Hodgkin’s lymphoma, nodular sclerosis.
Importance
Pulmonary parenchymal involvement in children is slightly more common with Hodgkin’s disease (HD) than non-Hodgkin’s lymphoma (NHL). It is seen in HD in approximately 12% of patients, most at the time of diagnosis and usually associated with mediastinal or hilar lymphadenopathy. Pulmonary involvement in NHL is seen in around 10% of cases and may occur without the presence of associated lymphadenopathy. The mechanism of spread of the disease to the lungs is typically by hematogenous or lymphangitic channels and less commonly by direct or endobronchial spread. On CT imaging, different patterns of involvement can be seen. A nodular pattern is characterized by the presence of single or multiple nodules, which may have irregular borders, air bronchograms, or cavitation (Figs. 17.1 and 17.2). Subpleural nodules or masses can also occur (Fig. 17.1). Lymphoma may also produce a pattern of lobar or segmental consolidation that can be confused with pneumonia (Fig. 17.3).
- Type
- Chapter
- Information
- Pearls and Pitfalls in Pediatric ImagingVariants and Other Difficult Diagnoses, pp. 56 - 61Publisher: Cambridge University PressPrint publication year: 2014