The incidence of leukaemic infiltration of the lungs, mediastinal lymph nodes and pleura varies with the course of the disease. Pulmonary infiltration by leukaemic cells is found at autopsy in nearly two-thirds of patients who have leukaemia. However, provided those patients with leukostasis (see below) are considered separately, leukaemic infiltration of the lungs, though very common pathologically, is usually asymptomatic and is rarely a cause of significant pulmonary opacity on a chest radiograph. When respiratory impairment is present, pulmonary infection, oedema or haemorrhage are more likely causes of the patient's symptoms. Imaging features include diffuse bilateral reticulation and patterns resembling interstitial oedema; lymphangitic carcinomatosis, small nodules, ground-glass opacification and consolidation have also been described.
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