Malignant Hematopoietic Disorders of the Lung
Hematopoietic tumors of the lung are uncommon. They comprise cases of non-Hodgkin lymphomas, classic Hodgkin lymphoma, plasmacytoma, and acute myeloid leukemia/myeloid sarcoma (Pina-Oviedo et al. Adv Anat Pathol 22:355-375, 2015). Primary lung involvement by these neoplasms is far less common than involvement by systemic disease. Histologically they are identical to their nodal or other extranodal counterparts. Therefore, the definition of a hematopoietic lung neoplasm as primary or secondary relies on clinical presentation and prior history of a hematolymphoid neoplasm. By imaging, lung hematopoietic tumors have a variable presentation depending on the subtype, and they are indistinguishable from localized pneumonia, sarcoidosis, tuberculosis, or a non-hematopoietic tumor (carcinoma, metastasis), and the diagnosis requires histopathologic confirmation (Zhang et al. Am J Med Sci 357:316-322, 2019; Sirajuddin et al. Radiographics 36:53-70, 2016). Tissue is usually obtained by interventional radiology in the form of a fine needle aspiration or a core biopsy or by video-assisted thoracoscopy and less common as an open lung biopsy. The differential diagnosis of hematolymphoid neoplasms of the lung varies depending on the entity and is discussed for each subtype of tumor.
