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Chest HRCT findings in acute transformation of adult T-cell lymphoma/leukemia

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Abstract

Objectives

To assess chest high-resolution computed tomography (HRCT) findings in patients with acute transformation of adult T cell leukaemia/lymphoma (ATLL).

Methods

We retrospectively identified 72 consecutive patients at our institution with ATLL between October 2000 and March 2014. The cases included acute type (n = 20), lymphoma type (n = 21), smouldering type (n = 24) and chronic type (n = 7). Sixteen (7 men, 9 women; aged 36–85 years, mean 63.3 years) of 31 patients (24 with smouldering and seven with chronic type; 51.6 %) developed acute transformation of ATLL, and had undergone chest HRCT examinations. Parenchymal abnormalities, enlarged lymph nodes, pericardial effusion, pleural effusion and skin lesions were evaluated on HRCT.

Results

Chest HRCT of 15 of the 16 patients showed abnormal findings, including ground-glass opacity (GGO) (n = 8), consolidation (n = 5), interlobular septal thickening (n = 5) and nodules (n = 5). Pleural effusion was found in five patients, lymph node enlargement in 10 patients and multiple skin thickening in two patients.

Conclusions

Almost all patients with acute transformation of ATLL had abnormal findings on chest HRCT, which consisted mainly of lymph node enlargement, GGO, interlobular septal thickening, nodules and bilateral pleural effusions.

Key points

• The recognition of CT findings of acute transformation is important

• Almost all patients with acute transformation have abnormal findings on HRCT

• Characteristic CT features are present in acute transformation of indolent ATLL

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Abbreviations

ATLL:

Adult T cell leukaemia/lymphoma

BAL:

Bronchoalveolar lavage

GGO:

Ground-glass opacity

HRCT:

High-resolution computed tomography

HTLV-1:

Human T-lymphotropic virus type 1

LDH:

Lactate dehydrogenase

TBLB:

Transbronchial lung biopsy

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Acknowledgments

The scientific guarantor of this publication is Fumito Okada. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because this study was retrospective. Written informed consent was not required for this study because this study was retrospective. None of the study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan

    Fumito Okada, Haruka Sato, Ahmad Khalid Omeri, Asami Ono, Kouhei Tokuyama, Yumiko Ando, Akira Matsumoto & Hiromu Mori

  2. Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Yufu, Oita, Japan

    Masao Ogata, Kazuhiro Kohno & Kuniko Takano

Authors
  1. Fumito Okada
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  2. Haruka Sato
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  3. Ahmad Khalid Omeri
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  4. Asami Ono
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  5. Kouhei Tokuyama
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  6. Yumiko Ando
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  10. Kuniko Takano
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  11. Hiromu Mori
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Correspondence to Fumito Okada.

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Okada, F., Sato, H., Omeri, A.K. et al. Chest HRCT findings in acute transformation of adult T-cell lymphoma/leukemia. Eur Radiol 25, 1607–1613 (2015). https://doi.org/10.1007/s00330-014-3565-3

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  • DOI: https://doi.org/10.1007/s00330-014-3565-3

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