Lymphoproliferative Disorder

Lymphoproliferative Disorder

Jud W. Gurney, MD, FACR

Axial CECT shows peripheral ground-glass centrilobular nodules image from follicular bronchiolitis.

Axial HRCT shows centrilobular nodules image and small scattered cysts image in a patient with lymphocytic interstitial pneumonia.



  • Lymphoproliferative disorder (LPD)

    • Encompasses neoplastic and nonneoplastic lesions

    • May regress spontaneously or progress to malignant lymphoma

    • Strongly related to either autoimmune diseases or immunosuppressed conditions

  • Bronchus associated lymphoid tissue (BALT) extends from nodal clusters in airway bifurcations to lymphocyte cluster at proximity of lymphatics in respiratory bronchiole

    • BALT has extensive distribution, positioned to handle a large number of inhaled or circulating antigens

    • Polyclonal proliferation consistent with benign disease; monoclonal proliferation of lymphocytes consistent with lymphoma

      • Clonal groups determined by special stains

  • Specific LPD entities include

    • Follicular bronchiolitis

    • Lymphocytic interstitial pneumonia (LIP)

    • Nodular lymphomatoid hyperplasia (pseudolymphoma)

    • Inflammatory myofibroblastic tumor (plasma cell granuloma or inflammatory pseudotumor)

    • Castleman disease

    • Angioimmunoblastic T-cell lymphoma (AILT)

    • Post-transplant lymphoproliferative disorder (PTLD)


General Features

  • Best diagnostic clue

    • Abnormalities of lymphoid tissue from

      • Mediastinum: Enlarged mediastinal hilar lymph nodes

      • Lung: Thickening bronchovascular vessels, centrilobular nodules, septal thickening

      • LPD entities often focal and do not involve all lymphoid tissue

CT Findings

Sep 20, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on Lymphoproliferative Disorder
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