Lymphocytic interstitial pneumonia in children with AIDS: high-resolution CT findings

Pulmonary involvement in children with acquired immunodeficiency syndrome ( AIDS) represents a wide spectrum of diseases. Among the non-infectious, non neoplastic affections associated with AIDS, lymphocytic interstitial pneumo nia (LIP) is now a well-recognized entity, but its radiological pattern stu died with high-resolution computed tomography (HRCT) has rarely been descri bed in children. The aim of this study was to illustrate the HRCT spectrum of pulmonary involvement in children with LIP and to evaluate its usefulnes s in the early diagnosis of this entity. Twelve children with AIDS, aged 3- 9 years (mean age 5 years 7 months), underwent chest radiographs and HRCT. A control group of 7 healthy aged-matched children was also studied in the same conditions. Diagnosis of LIP was based on clinical data and HRCT findi ngs. Eight children of 12 had a reticulonodular pattern on chest radiograph s. Two children had normal chest films and two children showed peribronchio lar thickening. High-resolution CT displayed micronodules, 1-3 mm in diamet er, with a perilymphatic distribution in all patients. High-resolution CT d emonstrated also subpleural nodules in children without reticulonodular opa cities on chest radiographs. High-resolution CT is able to define a more sp ecific pattern of abnormalities than conventional chest radiographs in chil dren with LIP, allows an earlier and more confident diagnosis and may be us eful for the detection of other pathologies associated with AIDS, such as o pportunistic infections or superimposed malignancies.