Acute lung disease in the immunocompromised host: CT and pathologic examination findings

Abstract

Purpose: To compare findings at computed tomography (CT) and pathologic examination in immuno-compromised patients with acute lung disease.

Materials and methods: Findings in 33 chest CT scans were compared with findings in pathologic specimens obtained at open lung biopsy (n = 29) or autopsy (n = 4) in 32 patients, aged 17-64 years.

Results: Nodules were the main abnormality at CT in 14 cases. Pathologically, the 14 nodules were due to infection (n = 10), bronchiolitis obliterans organizing pneumonia (BOOP) (n = 3), or lymphoma (n = 1). Areas of ground-glass attenuation were the main finding in 15 patients. These areas were a result of BOOP (n = 4), cytotoxic drug reaction (n = 4), infection (n = 4), lymphoma (n = 2), or nondiagnostic biopsy (n = 1). Consolidation was the main finding in four cases, being seen with BOOP (n = 2), infarction due to fungal infection (n = 1), and diffuse pulmonary hemorrhage (n = 1).

Conclusion: The pattern at CT accurately reflected the gross morphologic features seen in the pathologic specimens. Nodules were usually inflammatory lesions, often infections, and open lung biopsy usually revealed their specific origin.