Objective: To investigate the clinical, pathological and imaging characteristics, misdiagnosis and treatment of pulmonary non-Hodgkin's lymphoma with diffuse ground-glass opacities (GGO).
Methods: Six cases of pulmonary non-Hodgkin's lymphoma with diffuse GGO on chest CT diagnosed from January 2008 to March 2010 were retrospectively analyzed.
Results: There were 5 males and 1 female with average age of 52 years old (range: 30-59). The course had a range of 2-36 months. Most patients presented with dyspnea (n=5) and loss of weight (n=5). Enlargement of superficial lymph nodes (n=2) and hepatosplenomegaly (n=2) were also found. Laboratory tests showed that average hemoglobin decreased to 25 g/L and average serum LDH was 755 U/L. Chest CT showed diffuse GGO (n=2), diffuse GGO with consolidations (n=3), with wide lung septum (n=3), with multiple nodules (n=2), with enlargement of mediastinal lymph nodes (n=2). Diagnosis of the 6 cases were made by lung biopsy. Histological findings including intravascular lymphoma (n=2), diffuse large B cell lymphoma (n=2) and T cell lymphoma (n=2). The average follow-up period was 4 months (range: 2-6). Chemotherapy was administered in 4 patients with B cell lymphoma and all of them improved or remained stable. One patient with T cells lymphoma was lost to follow-up and another patient with T cell lymphoma died due to lung infection.
Conclusions: Non-Hodgkin's lymphoma with diffuse GGO on chest CT scan is rare. And its misdiagnosis is common due to a lack of specific clinical manifestations. And lung biopsy is necessary for an early diagnosis.