These cases are first detected on plain chest radiograph. A minority of patients present with a nonproductive cough, dyspnea or respiratory infection. The lesion is formed by massive aggregation of mature lymphocytes and reactive lymphoid follicles with true germinal centers. In contrast to malignant lymphomas, the lymphocytes have a polyclonal origin and do not invade the draining lymph nodes. Calcification and cavity formation are rare.
Pleural effusion is uncommon.
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