Primary pulmonarylymphoma (PPL)is defined as a malignant lymphoid proliferation within the lung parenchima in a patient without any detectable extra-pulmonary involvement [1-4]. PPL is a rare disease, representing 3-4% of extranodal lymphomas and 0.5-1% of all primary lung cancers. PPLs can be MALT lymphoma (the most common type, 60-90% of all PPLs) or other Non-Hodgkin or Hodgkin lymphoma. The second most common subtype is Diffuse Large B-cell Lymphoma (DLBCL, 10-20%) [5,6]. Clinical findings are often unspecific or absent and, in asymptomatic patients, incidental radiological findings...

Chest CT imaging findings of 30 cases of patologically proven PPL were reviewed retrospectively, in the period between 2002 and 2017. Histology was confirmed by lung biopsy. Patients Patients were 14 males and 16 females (aged 58-86, mean age 72 years). PPL subtypes were MALT lymphoma (N=23, 76.6%) and DLBCL (N=7, 23.4%). CT examinations and images interpretation CT exams were performed at baseline and after contrast medium administration (arterious and venous phase). The acquisitions were all in inspiration phasesand high resolutionimages were contiguously reconstructed at...

The following parenchymal patterns were observed: 11 single/multiple nodules (2/7 DLBCL, 28% - 9/23 MALT, 39%), 5 masses/mass-like consolidations (2/7 DLBCL, 28% - 3/23 MALT, 13%), 14 consolidations with air-bronchogram (3/7 DLBCL, 43% - 11/23 MALT, 47.8%), 16 ground-glass opacity with “crazy paving” pattern (3/7 DLBCL, 43% - 13/23 MALT, 56.5%), 10 angiogram sign (2/7 DLBCL, 28% - 8/23 MALT, 34.8%), 22 peri-lymphatic and/or peri-bronchovascular spread (4/7 DLBCL, 57.2% - 18/23 MALT, 78.2%), 15 associated lymphadenopathies (3/7 DLBCL, 43% - 12/23 MALT, 52.2%), 13 pleural/chest...

The main characteristics for both MALT lymphoma and DLBCL are masses/mass-like consolidations associated with ground-glass opacities and peri-lymphatic spread. In the appropriate clinical setting, all these characteristics should alert the radiologist to consider lymphoma among the possible differential diagnoses, always correlating the CT results with appropriate clinico-laboratory evaluations.

Dr. Diletta Cozzi Department of Emergency Radiology Careggi University Hospital L.go Brambilla, 3 50134 Florence Italy (IT) [email protected] Dr. Catia Dini: Department of Emergency Radiology - AOU Careggi, Florence Dr. Francesco Mungai: Department of Emergency Radiology - Careggi University Hospital, Florence Dr. Benedetta Puccini: Department of Hematology - Careggi University Hospital, Florence Dr. Luigi Rigacci: Department of Hematology- Careggi University Hospital, Florence Dr. Vittorio Miele: Department of Emergency Radiology - Careggi University Hospital, Florence

Sirajuddin A, Raparia K, Lewis VA et al (2016) Primary pulmonary lymphoid lesions: radiologic and pathologi findings. Radiographics 36;53-70. Doi: 10.1148/rg.2016140339 Koss MN (2004) Malignant and benign lymphoid lesions of the lung. Ann Diagn Pathol 8(3);167-87. Kurtin PJ,Myers JL, Adlakha H et al (2001) Pathologic and clinical features of primary pulmonary extranodal marginal zone B-cell lymphoma of MALT type. Am J Surg Pathol 25(8): 997-1008. Lee KS, Kim Y, Primack SL (1997) Imaging of pulmonary lymphoma. AJR Am J Roentgenol 168(2);339-45. Lee WK, Duddalwar VA,...