Furuta Kenjiro, Nakagawa Atsushi, Morita Kyohei, Tajiri Tomoko, Nishiyama Hideki, Nohgawa Masaharu, Ono Kazuo, Kobashi Yoichiro
Department of Respiratory Medicine, Japan Red Cross Society, Wakayama Medical Center.
Nihon Kokyuki Gakkai Zasshi. 2010 Jan;48(1):49-54.
Lymphomatoid granulomatosis is defined as an Epstein-Barr virus-associated B-cell lymphoma which possibly progresses to malignant lymphoma. The pulmonary lesions associated with this disease typically reveal multiple poorly defined nodules. A 71-year-old man with acute respiratory failure consulted a local doctor. A chest CT scan demonstrated a bilateral lower ground glass appearance. The shadow improved after pulse steroid therapy but it showed multiple nodules after the corticosteroid treatment was tapered. We finally diagnosed lymphomatoid granulomatosis (grade 2) based on the findings of a thoracoscopic lung biopsy. Pathologically, an angiocentric proliferation of large atypical lymphoid cells were observed which were positive for EBER (EBV-encoded small RNA). We herein report the details of this case because of its rare radiographic findings.
淋巴瘤样肉芽肿病被定义为一种与爱泼斯坦-巴尔病毒相关的B细胞淋巴瘤,可能会进展为恶性淋巴瘤。与该疾病相关的肺部病变通常表现为多个边界不清的结节。一名71岁急性呼吸衰竭男性患者咨询了当地医生。胸部CT扫描显示双侧下叶磨玻璃样改变。经脉冲类固醇治疗后阴影有所改善,但在皮质类固醇治疗逐渐减量后出现多个结节。我们最终根据胸腔镜肺活检结果诊断为淋巴瘤样肉芽肿病(2级)。病理上,观察到大型非典型淋巴细胞呈血管中心性增殖,EBER(EBV编码的小RNA)呈阳性。由于该病例罕见的影像学表现,我们在此报告其详细情况。