Pulmonary leukemic infiltration
Updates to Article Attributes
Pulmonary leukaemic infiltrations correspond to extravascular collections of leukaemic cells in the lung parenchyma. On imaging, although having a broad and nonspecific pattern of presentation, is commonly seen as thickening of the bronchovascular bundles and interlobular septa.
Epidemiology
They can be found in the lungs in around 24-64% of patients with leukaemia on autopsy. Multiple studies have shown no significant difference in the incidence of the leukaemic infiltrates among the four major types of leukaemia 6.
Pathology
The leukaemic infiltration is only called by its own, as a direct manifestation of leukaemia, in the absence of leukamialeukaemia-related complications that could be attributed as a cause (eg.: superimposed infection, alveolar haemorrhage, or pulmonary venous congestion) 6.
Histologically, there is atypical lymphocyte infiltration along the interstitium and alveolar spaces.
Radiographic features
It can have a variety of nonspecific radiographic appearances.
Plain radiograph
Most infiltrates do not appear on chest radiographs 1.
CT
Pulmonary consolidations in a variety of patterns have been described, including alveolar, interstitial, mixed, and peribronchial/perivascular patterns 3. There is a general tendency for abnormalities to involve the perilymphatic interstitium 1,6.
Other reported findings include 1,4:
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common
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thickening of bronchovascular bundles: ~ 80% 4
both smooth or nodular thickening have been described 6
prominence of peripheral pulmonary arteries: ~ 80% 4
non-lobular and non-segmental ground-glass opacities: ~90% 4
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-
uncommon
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peribronchovascular, centrilobular, or random in distribution 6
usually of small size and in a small number 6
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Differential diagnosis
Due to the variable appearance on CT, the differential diagnosis based on imaging may be broad 1:
See also
-<p><strong>Pulmonary leukaemic infiltrations </strong>correspond to extravascular collections of leukaemic cells in the lung parenchyma. On imaging, although having a broad and nonspecific pattern of presentation, is commonly seen as thickening of the bronchovascular bundles and interlobular septa.</p><h4>Epidemiology</h4><p>They can be found in the lungs in around 24-64% of patients with leukaemia on autopsy. Multiple studies have shown no significant difference in the incidence of the leukaemic infiltrates among the four major types of <a href="/articles/leukaemia">leukaemia</a> <sup>6</sup>.</p><h4>Pathology</h4><p>The leukaemic infiltration is only called by its own, as a direct manifestation of leukaemia, in the absence of leukamia-related complications that could be attributed as a cause (eg.: superimposed infection, alveolar haemorrhage, or pulmonary venous congestion) <sup>6</sup>. </p><p>Histologically, there is atypical lymphocyte infiltration along the interstitium and alveolar spaces. </p><h4>Radiographic features</h4><p>It can have a variety of nonspecific radiographic appearances.</p><h5>Plain radiograph</h5><p>Most infiltrates do not appear on chest radiographs <sup>1</sup>.</p><h5>CT</h5><p>Pulmonary consolidations in a variety of patterns have been described, including alveolar, interstitial, mixed, and peribronchial/perivascular patterns <sup>3</sup>. There is a general tendency for abnormalities to involve the perilymphatic interstitium <sup>1,6</sup>.</p><p>Other reported findings include <sup>1,4</sup>:</p><ul>-<li>common<ul>- +<p><strong>Pulmonary leukaemic infiltrations </strong>correspond to extravascular collections of leukaemic cells in the lung parenchyma. On imaging, although having a broad and nonspecific pattern of presentation, is commonly seen as thickening of the bronchovascular bundles and interlobular septa.</p><h4>Epidemiology</h4><p>They can be found in the lungs in around 24-64% of patients with leukaemia on autopsy. Multiple studies have shown no significant difference in the incidence of the leukaemic infiltrates among the four major types of <a href="/articles/leukaemia">leukaemia</a> <sup>6</sup>.</p><h4>Pathology</h4><p>The leukaemic infiltration is only called by its own, as a direct manifestation of leukaemia, in the absence of leukaemia-related complications that could be attributed as a cause (eg.: superimposed infection, alveolar haemorrhage, or pulmonary venous congestion) <sup>6</sup>. </p><p>Histologically, there is atypical lymphocyte infiltration along the interstitium and alveolar spaces. </p><h4>Radiographic features</h4><p>It can have a variety of nonspecific radiographic appearances.</p><h5>Plain radiograph</h5><p>Most infiltrates do not appear on chest radiographs <sup>1</sup>.</p><h5>CT</h5><p>Pulmonary consolidations in a variety of patterns have been described, including alveolar, interstitial, mixed, and peribronchial/perivascular patterns <sup>3</sup>. There is a general tendency for abnormalities to involve the perilymphatic interstitium <sup>1,6</sup>.</p><p>Other reported findings include <sup>1,4</sup>:</p><ul>
-<a href="/articles/thickening-of-bronchovascular-bundles">thickening of bronchovascular bundles</a>: ~ 80% <sup>4</sup><ul><li>both smooth or nodular thickening have been described <sup>6</sup>-</li></ul>-</li>-<li>prominence of peripheral pulmonary arteries: ~ 80% <sup>4</sup>-</li>-<li>non-lobular and non-segmental <a href="/articles/ground-glass-opacification-3">ground-glass opacities</a>: ~90% <sup>4</sup>- +<p>common</p>
- +<ul>
- +<li>
- +<p><a href="/articles/thickening-of-bronchovascular-bundles">thickening of bronchovascular bundles</a>: ~ 80% <sup>4</sup></p>
- +<ul><li><p>both smooth or nodular thickening have been described <sup>6</sup></p></li></ul>
- +<li><p>prominence of peripheral pulmonary arteries: ~ 80% <sup>4</sup></p></li>
- +<li><p>non-lobular and non-segmental <a href="/articles/ground-glass-opacification-3">ground-glass opacities</a>: ~90% <sup>4</sup></p></li>
-<li>uncommon<ul>-<a href="/articles/pulmonary-nodules">pulmonary nodules </a><ul>-<li>peribronchovascular, centrilobular, or random in distribution <sup>6</sup>-</li>-<li>usually of small size and in a small number <sup>6</sup>-</li>- +<p>uncommon</p>
- +<ul>
- +<li>
- +<p><a href="/articles/pulmonary-nodules">pulmonary nodules</a></p>
- +<ul>
- +<li><p>peribronchovascular, centrilobular, or random in distribution <sup>6</sup></p></li>
- +<li><p>usually of small size and in a small number <sup>6</sup></p></li>
-<li>-<a href="/articles/focal-homogeneous-pulmonary-opacities">focal homogeneous pulmonary opacities</a> </li>- +<li><p><a href="/articles/focal-homogeneous-pulmonary-opacities">focal homogeneous pulmonary opacities</a> </p></li>
-<li><a href="/articles/pulmonary-oedema">pulmonary oedema</a></li>-<li><a href="/articles/pulmonary-haemorrhage">pulmonary haemorrhage</a></li>-<li><a href="/articles/pulmonary-infection">pulmonary infection</a></li>-</ul><h4>See also</h4><ul><li><a href="/articles/pulmonary-lymphoma">pulmonary lymphoma</a></li></ul>- +<li><p><a href="/articles/pulmonary-oedema">pulmonary oedema</a></p></li>
- +<li><p><a href="/articles/pulmonary-haemorrhage">pulmonary haemorrhage</a></p></li>
- +<li><p><a href="/articles/pulmonary-infection">pulmonary infection</a></p></li>
- +</ul><h4>See also</h4><ul><li><p><a href="/articles/pulmonary-lymphoma">pulmonary lymphoma</a></p></li></ul>
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