Thoracic CT Scan Findings in Patients with Confirmed Hematologic Malignancies Admitted to the Hospital with Acute Pulmonary Symptoms

Abstract

Background: Hematologic malignancies are the fifth most common malignancies worldwide. Pulmonary symptoms are among the patient’s common complaints. Early diagnosis based on patient symptoms, laboratory testing, and imaging may lead to an appropriate therapeutic approach. Objectives: To evaluate thoracic computed tomography (CT) scan findings in known cases of hematologic malignancy with acute respiratory symptoms. Methods: A cross-sectional study was conducted on 200 patients with hematologic malignancies admitted to Khansari cancer center for acute pulmonary symptoms, from December 2019 to May 2020. Collected data included demographic data, physical examination, laboratory tests and findings of thoracic CT images. Descriptive analysis and chi-Square test were performed to analyze the data using SPSS version 20. Results: Non-Hodgkin lymphoma was the most common malignancy, accounting for 48% of total cases. The most common radiological findings included atelectasis (49%), followed by pleural effusion (42%), mediastinal lymphadenopathy (38.5%), consolidation (37%), and ground-glass opacities (33.5%). Mediastinal lymphadenopathy was more prevalent in patients diagnosed with lymphoma. Among pulmonary pathologies, pneumonia was the most prevalent disease (41.5%), followed by small airway disease (13.5%), mediastinal lymphadenopathy (12.5%), chronic pulmonary disease (6.5%), and pulmonary metastasis (6%). Normal thoracic CT scan was detected in 20% of participants. Overall assessment of clinical symptoms, laboratory tests, and imaging findings did not lead to the diagnosis of acute lung involvement in 5.5% of study participants, because complete clinical data were not available in some participants. Conclusions: Assessment of the most common thoracic imaging findings in patients diagnosed with hematologic malignancies, may help make better diagnosis and planning of a rapid therapeutic approach.