tetano
Editor, Senior Moderator
Korean J Radiol
. 2023 Feb 16.
doi: 10.3348/kjr.2022.0844. Online ahead of print.
Migratory Pneumonia in Prolonged SARS-CoV-2 Infection in Patients Treated With B-cell Depletion Therapies for B-cell Lymphoma
Jongmin Lee[SUP] #[/SUP][SUP] 1 [/SUP], Raeseok Lee[SUP] #[/SUP][SUP] 2 [/SUP], Kyongmin Sarah Beck[SUP] 3 [/SUP], Dae Hee Han[SUP] 4 [/SUP], Gi June Min[SUP] 5 [/SUP], Suyon Chang[SUP] 4 [/SUP], Jung Im Jung[SUP] 4 [/SUP], Dong-Gun Lee[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: To report the clinical and radiological characteristics of patients with underlying B-cell lymphoma and coronavirus disease 2019 (COVID-19) showing migratory airspace opacities on serial chest computed tomography (CT) with persistent COVID-19 symptoms.
Materials and methods: From January 2020 to June 2022, of the 56 patients with underlying hematologic malignancy who had undergone chest CT more than once at our hospital after acquiring COVID-19, seven adult patients (5 female; age range, 37-71 years; median age, 45 years) who showed migratory airspace opacities on chest CT were selected for the analysis of clinical and CT features.
Results: All patients had been diagnosed with B-cell lymphoma (three diffuse large B-cell lymphoma and four follicular lymphoma) and had received B-cell depleting chemotherapy, including rituximab, within three months prior to COVID-19 diagnosis. The patients underwent a median of 3 CT scans during the follow-up period (median 124 days). All patients showed multifocal patchy peripheral ground glass opacities (GGOs) with basal predominance in the baseline CTs. In all patients, follow-up CTs demonstrated clearing of previous airspace opacities with the development of new peripheral and peribronchial GGO and consolidation in different locations. Throughout the follow-up period, all patients demonstrated prolonged COVID-19 symptoms accompanied by positive polymerase chain reaction results from nasopharyngeal swabs, with cycle threshold values of less than 25.
Conclusion: COVID-19 patients with B-cell lymphoma who had received B-cell depleting therapy and are experiencing prolonged SARS-CoV-2 infection and persistent symptoms may demonstrate migratory airspace opacities on serial CT, which could be interpreted as ongoing COVID-19 pneumonia.
Keywords: B-cell depletion; Computed tomography; Coronavirus disease 2019; Lymphoma; Rituximab; SARS-CoV-2.
. 2023 Feb 16.
doi: 10.3348/kjr.2022.0844. Online ahead of print.
Migratory Pneumonia in Prolonged SARS-CoV-2 Infection in Patients Treated With B-cell Depletion Therapies for B-cell Lymphoma
Jongmin Lee[SUP] #[/SUP][SUP] 1 [/SUP], Raeseok Lee[SUP] #[/SUP][SUP] 2 [/SUP], Kyongmin Sarah Beck[SUP] 3 [/SUP], Dae Hee Han[SUP] 4 [/SUP], Gi June Min[SUP] 5 [/SUP], Suyon Chang[SUP] 4 [/SUP], Jung Im Jung[SUP] 4 [/SUP], Dong-Gun Lee[SUP] 2 [/SUP]
Affiliations
- PMID: 36907590
- DOI: 10.3348/kjr.2022.0844
Abstract
Objective: To report the clinical and radiological characteristics of patients with underlying B-cell lymphoma and coronavirus disease 2019 (COVID-19) showing migratory airspace opacities on serial chest computed tomography (CT) with persistent COVID-19 symptoms.
Materials and methods: From January 2020 to June 2022, of the 56 patients with underlying hematologic malignancy who had undergone chest CT more than once at our hospital after acquiring COVID-19, seven adult patients (5 female; age range, 37-71 years; median age, 45 years) who showed migratory airspace opacities on chest CT were selected for the analysis of clinical and CT features.
Results: All patients had been diagnosed with B-cell lymphoma (three diffuse large B-cell lymphoma and four follicular lymphoma) and had received B-cell depleting chemotherapy, including rituximab, within three months prior to COVID-19 diagnosis. The patients underwent a median of 3 CT scans during the follow-up period (median 124 days). All patients showed multifocal patchy peripheral ground glass opacities (GGOs) with basal predominance in the baseline CTs. In all patients, follow-up CTs demonstrated clearing of previous airspace opacities with the development of new peripheral and peribronchial GGO and consolidation in different locations. Throughout the follow-up period, all patients demonstrated prolonged COVID-19 symptoms accompanied by positive polymerase chain reaction results from nasopharyngeal swabs, with cycle threshold values of less than 25.
Conclusion: COVID-19 patients with B-cell lymphoma who had received B-cell depleting therapy and are experiencing prolonged SARS-CoV-2 infection and persistent symptoms may demonstrate migratory airspace opacities on serial CT, which could be interpreted as ongoing COVID-19 pneumonia.
Keywords: B-cell depletion; Computed tomography; Coronavirus disease 2019; Lymphoma; Rituximab; SARS-CoV-2.