Blood Res.  2022 Sep;57(3):216-222. 10.5045/br.2022.2022085.

Chest multidetector computed tomography imaging of COVID-19 pneumonia patients with hematologic malignancies

• El-Badrawy A
• Elbadrawy N

• KMID: 2533249
• DOI: http://doi.org/10.5045/br.2022.2022085

Abstract

Background
Data on the association between coronavirus disease 2019 (COVID-19) and the epidemiology and outcomes of hematological malignancies are limited. Hence, the present study aimed to assess the imaging findings using chest multidetector computed tomography (MDCT) in patients with hematologic malignancies who developed COVID-19 pneumonia.
Methods
This retrospective study included two groups, the first group consisted of COVID-19 infected patients with hematologic malignancies (100 patients), while the second group consisted of COVID-19 infected patients without hematologic malignancies or other comorbidities (100 patients). The hematological malignancies included in this study were non-Hodgkin’s lymphoma (40 patients), acute myeloid leukemia (25 patients), chronic lymphocytic leukemia (15 patients), multiple myeloma (10 patients), Hodgkin’s lymphoma (8 patients), and myelodysplastic syndrome (2 patients). Chest multidetector CT imaging was performed in all patients to assess for ground-glass opacity, consolidation, pleural effusion, and airway abnormalities.
Results
More than one CT finding was reported in each patient. No significant difference was observed in the ground-glass opacities (P =0.0594), nodule formation (P =0.2278), or airway thickening/dilatation (P =0.0566) between the two groups; meanwhile, a significant difference was observed in the degree of consolidation, the number of lobes affected, and pleural effusion (P =0.0001) as well as in the total lung severity (P =0.0001); minimal, mild, and severe affection rates; and (P =0.0047) moderate affection rates.
Conclusion
Early and reliable diagnosis of lung disease in COVID-19-infected patients may be achieved through multidetector CT imaging. Patients with hematological malignancies are more likely to have severe COVID-19 pneumonia, and radiologists should recognize the CT characteristics of this infection.

Keyword

Multi-detector computed tomography; COVID-19; Pneumonia; Hematologic malignancies

Figure

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  Fig. 1 63-year-old male patient with coronavirus disease (COVID-19) and history of chronic lymphocytic leukemia. Multidetector CT scan of the chest (A) showed bilateral pleural effusions (asterisks) and malignant lymphadenopathy in the superior mediastinum (arrows); (B) bilateral ground-glass opacities (asterisks); (C) bronchial dilatation (arrow), bilateral ground-glass opa-cities (asterisks), and right pneum-onic consolidation (right triangles); and (D) bilateral ground-glass opa-cities (asterisks), bronchial dilatation (arrows), and interlobular septal thickening.

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  Fig. 2 36-year-old woman with coronavirus disease (COVID-19) and history of non-Hodgkin lym-phoma. Multidetector CT scan of the chest (A, B) showed multiple bilateral axillary and superior med-iastinal looking malignant lymphad-enopathy (arrows) and (C, D) ground-glass opacities (asterisks), interlobular septal thick-ening, and bronchial dilatation (arrow). Follow- up MDCT scan of the chest after 11 days (E, F) showed improvement in ground-glass opacities (asterisks).

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  Fig. 3 55-year-old man with coronavirus disease (COVID-19) and history of acute myeloid leukemia. Multidetector CT scan of the chest (A, B) showed ground- glass opacities (arrows) and nodules (triangles). Follow-up MDCT scan of the chest after 10 days (C, D) showed increased ground-glass opacities (arrows) with newly developed mild left pleural effusion (asterisk).

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  Fig. 4 45-year-old woman with coronavirus disease (COVID-19) and history of multiple myeloma. Multidetector CT scan of the chest (A) showed dilated cardiac chamber, pericardial (arrow), and pleural effusions (asterisks) and (B, C) bronchial dilatation (triangle) and ground-glass opacities (arrows). Follow-up MDCT scan of the chest after 8 days (D) showed progression of pericardial effusion (arrow) and pleural effusion (asterisks) and (E, F) Ground-glass opacities (arrows) and a newly developed consolidation (oval).

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