CTICasesPulmonary Infiltration by Chronic Lymphocytic Leukemia (CLL)
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Imaging findings
CT images of a 65-year-old male with a history of CLL show progressive interlobular septal thickening, ground-glass opacities, and areas of crazy-paving predominantly in the lower lobes. Transbronchial biopsy with CD5 immunohistochemical staining confirmed infiltration of CLL cells within the pulmonary interstitium.
Key takeaways
Chronic lymphocytic leukemia can rarely infiltrate the pulmonary parenchyma, presenting as progressive septal thickening and crazy-paving that can mimic pulmonary alveolar proteinosis, recurrent aspiration, or interstitial pneumonia. Immunohistochemical staining is crucial to confirm leukemic infiltration.
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