Chest computed tomography findings in febrile patients with hematological malignancies

Background: Pulmonary complications, infectious or non-infectious, are very common complications in patients with hematological malignancy. This study addresses the role of computed tomography (CT) scan in assisting in the diagnosis of pulmonary complications in those patients. Patients and method: This is a prospective study, performed in Baghdad teaching hospital, Medical city, Baghdad, Iraq where 50 patients with and 50 patients without hematological malignancy presented with fever of unknown cause at time of admission in the period from April 2017 to February 2018. Chest CT scan was performed for every patient and the findings were compared between the two groups. Results: There was no statistical difference between the two groups regarding the site, distribution or pattern of any intrapulmonary lesion, Bacterial pneumonia is the most common cause of pulmonary lesions followed by fungal infection in patients with hematological malignancy, compared to Bacterial pneumonia then tuberculosis in patients without hematological malignancy. Specific signs found in CT scan (Halo sign , Reverse halo sign, Tree in Bud sign) are more likely to be encountered in patients with hematological malignancy (66% versus 33%, P-value 0.032). Conclusion: There is no difference in distribution or pattern of imaging findings. The most common cause of CT scan lesions in both groups is bacterial infections. CT scan, intertwined with the clinical data of the patients, proves to be a valuable tool in reaching the final diagnosis especially in those with fever, and may assist in the early detection, assessing of severity, and treatment response of those complications, hopefully decreasing mortality and morbidity.