Lung Nodules and Masses in non-HIV Immunocompromised Patients: A Clinical-Imaging Algorithmic Approach

Abstract

Topic importance: The incidence of pulmonary nodules and masses in non-HIV immunocompromised patients has significantly increased due to advancements in hematopoietic stem cell transplantation (HSCT), solid organ transplantation (SOT), and the widespread use of chemotherapy and immunosuppressive therapies. Differentiating between infectious and non-infectious causes is critical for appropriate diagnosis and management, especially as radiological and clinical presentations can be nonspecific.

Review findings: This review provides a practical framework for evaluating pulmonary nodules and masses in non-HIV immunocompromised patients, incorporating clinical, immunological, and radiological features. It emphasizes the importance of differentiating between infectious and non-infectious etiologies based on imaging and clinical context. The review highlights the importance of correlating imaging features with the patient's immune status and underlying clinical conditions to narrow down the differential diagnosis.

Summary: Pulmonary nodules and masses in immunocompromised patients represent a diagnostic challenge due to overlapping radiological and clinical presentations. By integrating clinical context, immune status, and imaging findings, clinicians can more accurately diagnose and manage these lesions, improving patient outcomes. This review presents an algorithmic approach for differentiating between various causes of pulmonary nodules and masses in non-HIV immunocompromised individuals, providing a valuable tool for clinical practice.

Keywords: CT findings; hematopoietic stem cell transplantation; immunocompromised host; infective etiologies; lung masses; neoplasms; non-HIV patients; non-infective etiologies; opportunistic infections; pulmonary nodules; solid organ transplantation.