Patterns of thoracic involvement on MDCT in patients with hematological malignancies

Abstract

Hematological malignancies (HMs) are one of the commonest malignancies with high incidence of thoracic manifestations. The aim of this retrospective descriptive cross-sectional study was to describe the spectrum and frequency of thoracic MDCT findings in adult patients with hematological malignancies presenting with respiratory symptoms in a real-world clinical setting. No diagnostic performance metrics were calculated. Eighty-two patients with HMs were included in the study who presented with respiratory symptoms and whom chest CT data was available to assess different forms of thoracic involvement. Eighty patients completed the study. Non-Hodgkin lymphoma (NHL) patients were the commonest (42.5%). Dyspnea was the commonest complaint (27.5%). 68 patients had positive CT findings (group A) and 12 patients showed normal CT (group B). Positive thoracic and axillary pathological lymphadenopathies were the commonest CT findings (52.5% and 40% respectively) followed by parenchymal infiltration (30%). A statistical association was noted between osseous lesions and multiple myeloma (MM) (P-value 0.001) also a statistical association was found between the thoracic lymphadenopathies and NHL (P-value 0.032). A statistical observation was found between MM and single compartmental affection (P-value 0.009). A statistical occurrence was found between the female sex and positive CT findings (P-value 0.048). A statistical observation was found between the incidence of different CT findings and the patients with NHL (P-value 0.049). A statistical occurrence was observed between chemotherapy history and the negative CT findings (P-value 0.006). This study provides a descriptive overview of thoracic MDCT findings in patients with hematological malignancies presenting with respiratory symptoms. The results highlight the diversity of imaging patterns encountered in routine clinical practice. Further prospective studies with standardized diagnostic confirmation are required to better define the clinical significance of these findings.