1. What is the most common cause of a perilymphatic distribution of nodules in the lungs?
A. Tuberculosis
B. Sarcoidosis
C. Lymphangitic carcinomatosis
D. MALT lymphoma
Answer: B. Sarcoidosis
Comment: Sarcoidosis is the most common cause of perilymphatic nodules, characterized by non-caseating granulomas along lymphatic pathways.
“Sarcoidosis typically demonstrates a perilymphatic distribution of nodules along bronchovascular bundles, interlobular septa, and subpleural regions.”
Reference: Radiopaedia: Sarcoidosis
2. Which of the following conditions is most likely associated with lymphoid interstitial pneumonia (LIP)?
A. Sjögren syndrome
B. Sarcoidosis
C. Tuberculosis
D. Primary effusion lymphoma
Answer: A. Sjögren syndrome
Comment: LIP is frequently associated with autoimmune diseases, particularly Sjögren syndrome and HIV infection.
“Lymphoid interstitial pneumonia is strongly linked to Sjögren syndrome, presenting as diffuse lymphoid hyperplasia along interstitial lymphatic pathways.”
Reference: Radiographics: Lymphoid Disorders
3. What imaging finding best characterizes lymphangitic carcinomatosis on CT?
A. Ground-glass opacity with calcifications
B. Perilymphatic nodules with mediastinal lymphadenopathy
C. Diffuse interlobular septal thickening with nodular beading
D. Subpleural fibrosis with traction bronchiectasis
Answer: C. Diffuse interlobular septal thickening with nodular beading
Comment: Lymphangitic carcinomatosis manifests as interlobular septal thickening with irregular nodular beading, reflecting malignant infiltration of lymphatics.
“Lymphangitic carcinomatosis involves diffuse interlobular septal thickening with nodularity, indicative of lymphatic tumor spread.”
Reference: Radiopaedia: Lymphangitic Carcinomatosis
4. Which of the following lymphoproliferative disorders is most commonly confined to the lungs?
A. Hodgkin lymphoma
B. MALT lymphoma
C. Multicentric Castleman disease
D. Primary effusion lymphoma
Answer: B. MALT lymphoma
Comment: MALT lymphoma is the most common primary pulmonary lymphoma, arising from mucosa-associated lymphoid tissue within the lungs.
“Pulmonary MALT lymphoma is a primary extranodal marginal zone lymphoma confined to the lungs, often associated with chronic antigenic stimulation.”
Reference: Radiographics: MALT Lymphoma
5. Which distribution pattern is most characteristic of perilymphatic nodules on CT?
A. Random distribution throughout the lung parenchyma
B. Centered along interlobular septa and bronchovascular bundles
C. Confined to the subpleural regions only
D. Scattered in a centrilobular distribution
Answer: B. Centered along interlobular septa and bronchovascular bundles
Comment: Perilymphatic nodules typically follow the lymphatic pathways along bronchovascular bundles, interlobular septa, and subpleural regions.
“Perilymphatic nodules are predominantly distributed along bronchovascular bundles, subpleural areas, and interlobular septa.”
Reference: Radiopaedia: Perilymphatic Distribution
6. Which autoimmune condition is most commonly associated with pulmonary nodular lymphoid hyperplasia (NLH)?
A. Systemic lupus erythematosus
B. Rheumatoid arthritis
C. Sjögren syndrome
D. Hashimoto thyroiditis
Answer: C. Sjögren syndrome
Comment: Nodular lymphoid hyperplasia (NLH) in the lungs is most often linked to Sjögren syndrome, a systemic autoimmune condition.
“Pulmonary nodular lymphoid hyperplasia is frequently associated with autoimmune diseases, particularly Sjögren syndrome.”
Reference: Radiopaedia: Nodular Lymphoid Hyperplasia
7. Which infectious agent is strongly associated with lymphomatoid granulomatosis (LG)?
A. Epstein–Barr virus (EBV)
B. Mycobacterium tuberculosis
C. Chlamydia pneumoniae
D. Cytomegalovirus (CMV)
Answer: A. Epstein–Barr virus (EBV)
Comment: Lymphomatoid granulomatosis is strongly associated with Epstein–Barr virus and presents with angiocentric lymphoproliferative lesions.
“Epstein–Barr virus is implicated in lymphomatoid granulomatosis, which exhibits angiocentric and necrotic lymphoproliferative patterns.”
Reference: PubMed: Lymphomatoid Granulomatosis
8. Which condition is most likely to present with pleural effusions and perilymphatic nodules in HIV-positive patients?
A. Sarcoidosis
B. Primary effusion lymphoma (PEL)
C. Lymphoid interstitial pneumonia (LIP)
D. Tuberculosis
Answer: B. Primary effusion lymphoma (PEL)
Comment: PEL is an HIV-associated lymphoma that commonly presents with pleural effusions and may involve lymphatic nodules in the lungs.
“Primary effusion lymphoma often occurs in HIV-positive individuals, presenting with pleural effusions and occasional pulmonary involvement.”
Reference: Radiographics: Primary Effusion Lymphoma
9. What distinguishes MALT lymphoma from lymphangitic carcinomatosis on CT?
A. Nodules along lymphatic pathways
B. Ground-glass opacity in the periphery
C. Well-defined masses with air bronchograms
D. Interlobular septal thickening with nodular beading
Answer: C. Well-defined masses with air bronchograms
Comment: MALT lymphoma is characterized by well-defined pulmonary masses or consolidations with air bronchograms, while lymphangitic carcinomatosis presents as diffuse septal thickening.
“MALT lymphoma typically manifests as solitary or multiple masses with air bronchograms, distinguishing it from diffuse patterns like lymphangitic carcinomatosis.”
Reference: Radiopaedia: MALT Lymphoma
10. Which of the following findings on CT suggests sarcoidosis rather than a neoplastic process?
A. Asymmetric nodules confined to one lobe
B. Bilateral, symmetrical hilar lymphadenopathy
C. Pleural effusion with thickened septa
D. Peripheral subpleural masses
Answer: B. Bilateral, symmetrical hilar lymphadenopathy
Comment: Symmetrical hilar lymphadenopathy with a perilymphatic nodule distribution is highly characteristic of sarcoidosis.
“Bilateral hilar lymphadenopathy with perilymphatic nodules along bronchovascular bundles and interlobular septa is a hallmark of sarcoidosis.”
Reference: Radiopaedia: Sarcoidosis Imaging