Bräunlich J, Seyfarth H-J, Gessner C, Gradistanac T, Wirtz H
Universität Leipzig, Abteilung Pneumologie.
Pneumologie. 2009 Dec;63(12):697-701. doi: 10.1055/s-0029-1214999. Epub 2009 Nov 3.
Lymphomatoid granulomatosis (LYG) is a rare disease with an unknown pathogenesis. It is considered as a B-cell disorder with an uncertain malignant potential. The disease is classified as an angiocentric and angiodestructive lymphoproliferative disorder. EBV-association (LMP1) and the detection of the surface antigens CD20 and CD30 are the characteristic pathological findings. The lung, the nervous system, the kidneys and the liver are affected most frequently. In the present report the case of a 79-year-old man is described, who showed a cavity in the upper right lobe which was opened out into the trachea. The initial CXR and CT scan demonstrated a large nodular air space opacity (reversed halo sign) on the upper right area and a smaller one on the left side. In addition to CT and bronchoscopy, a surgical biopsy was performed to confirm the diagnosis of lymphomatoid granulomatosis. Treatment consisted in chemotherapy with rituximab, cyclophosphamide, vincristine and prednisolone (R-CVP). Three months after confirmation of diagnosis the patient died of an abscess-forming pneumonia.
淋巴瘤样肉芽肿病(LYG)是一种发病机制不明的罕见疾病。它被认为是一种具有不确定恶性潜能的B细胞疾病。该疾病被归类为血管中心性和血管破坏性淋巴增生性疾病。EBV关联(LMP1)以及表面抗原CD20和CD30的检测是其特征性病理表现。肺、神经系统、肾脏和肝脏是最常受累的部位。在本报告中,描述了一名79岁男性的病例,其右上叶有一个通向气管的空洞。最初的胸部X线片和CT扫描显示右上区域有一个大的结节状气腔混浊(反晕征),左侧有一个较小的。除了CT和支气管镜检查外,还进行了手术活检以确诊淋巴瘤样肉芽肿病。治疗包括使用利妥昔单抗、环磷酰胺、长春新碱和泼尼松龙(R-CVP)进行化疗。确诊三个月后,患者死于脓肿形成性肺炎。