CTICasesCommon Variable Immunodeficiency with Lymphocytic Interstitial Pneumonia
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Imaging findings
Serial CT studies show multiple bilateral nodular opacities with poorly defined margins and a mixture of ground-glass and solid attenuation, associated with cystic spaces and mild mediastinal lymphadenopathy. Over time, these opacities demonstrate a classic spontaneous "waxing and waning" pattern, with some nodules resolving and new ones developing without active treatment. PET CT shows that some of these lesions are FDG-avid.
Key takeaways
Common variable immunodeficiency (CVID) is frequently associated with non-infectious, benign lymphoproliferative disorders of the lung, such as lymphocytic interstitial pneumonia (LIP), follicular bronchiolitis, or granulomatous-lymphocytic interstitial lung disease (GLILD). A hallmark clinical and radiologic feature of these CVID-associated lymphoproliferative processes is their spontaneous waxing and waning appearance over time in the absence of therapy.
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