CTICasesDiffuse Large B-cell Lymphoma with Extensive Extranodal Involvement
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Imaging findings
CT showed extensive lung disease characterized by numerous nodules and ill-defined ground glass opacities, possibly centered about bronchovascular bundles. There was a small left pleural effusion. Bone lesions were present, exemplified by a rib lesion with associated extrapleural soft tissue mass. PET imaging demonstrated widespread disease, including extensive bone involvement (ribs, sternum), liver lesions, and lymphadenopathy, in addition to the pulmonary findings.
Key takeaways
Diffuse large B-cell lymphoma can present with highly varied and extensive pulmonary involvement, often with a combination of nodular and ill-defined opacities. The presence of systemic symptoms (night sweats, fatigue) and widespread extranodal disease (bone, liver, lymph nodes) on PET is typical of aggressive lymphoma. The lung presentation can be atypical, making it challenging to recognize without the full clinical and PET context.
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