Higashiyama Asumi, Hashino Satoshi, Onozawa Masahiro, Takahata Mutsumi, Okada Kohei, Kahata Kaoru, Taniguchi Natsuko, Nasuhara Yasuyuki, Kubota Kanako, Fujimoto Nozomu, Matsuno Yoshihiro, Nishimura Masahiro, Asaka Masahiro
Third Department of Internal Medicine, Hokkaido University Hospital.
Rinsho Ketsueki. 2010 May;51(5):353-6.
A 61-year-old man was admitted to our hospital with dyspnea on effort. Neither computed tomography scan nor chest X-ray film detected any specific findings that could explain hypoxemia. Since (67)Ga scintigraphy showed abnormal uptake in the bilateral lungs, transbronchial lung biopsy (TBLB) was performed. The TBLB specimen was diagnosed as intravascular large B-cell lymphoma (IVLBCL). There was no involvement of any other organ considered typical of IVLBCL. In cases showing clinical findings such as hypoxia despite mild pulmonary radiographic changes, a definitive diagnosis should be made using methods such as TBLB with consideration given to the possibility of IVLBCL.
一名61岁男性因劳力性呼吸困难入院。计算机断层扫描和胸部X线片均未发现任何可解释低氧血症的特异性表现。由于镓（67）闪烁扫描显示双侧肺部有异常摄取，因此进行了经支气管肺活检（TBLB）。TBLB标本被诊断为血管内大B细胞淋巴瘤（IVLBCL）。未发现IVLBCL典型累及的其他任何器官。对于尽管肺部影像学改变轻微但有缺氧等临床表现的病例，应考虑IVLBCL的可能性，采用TBLB等方法进行明确诊断。
