Liu Chunli, Lai Ning, Zhou Ying, Li Shiyue, Chen Rongchang, Zhang Nuofu
State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University China.
Int J Clin Exp Pathol. 2014 Aug 15;7(9):6301-6. eCollection 2014.
Intravascular lymphoma is a very rare form of large B-cell non-Hodgkin's lymphoma which is characterized by selective growth of lymphoma cells within the lumina of small blood vessels. We report a 64-year-old woman visited hospital because of persistent cough, intermittent high fever as high as 38.7 °C and occasional shortness of breath. Her chest CT showed left upper lobe pneumonia and tuberculosis skin test (PPD test) was positive. She was suspected with tuberculosis and treated with anti-tuberculosis drugs. However, her symptoms and general condition deteriorated, and she visited our hospital. She had no abnormal findings on physical examination, but had abnormal laboratory findings, including decreased hemoglobin, elevated LDH and C-reactive protein. Arterial blood gas analysis showed moderate hypoxaemia. A chest radiograph showed pneumonia in whole lung and CT showed diffused ground glass opacities in both lung fields. Lung biopsy confirmed a diagnosis of intravascular large B-cell lymphoma. Primary pulmonary manifestation is very rare. The diagnosis is based on the histopathology and immunohistochemistry.
血管内淋巴瘤是一种非常罕见的大B细胞非霍奇金淋巴瘤，其特征是淋巴瘤细胞在小血管腔内选择性生长。我们报告一名64岁女性因持续咳嗽、间歇性高热至38.7℃及偶尔气短就诊。她的胸部CT显示左上叶肺炎，结核菌素皮肤试验（PPD试验）呈阳性。她被怀疑患有结核病并接受抗结核药物治疗。然而，她的症状和一般状况恶化，随后前来我院就诊。她体格检查无异常发现，但实验室检查结果异常，包括血红蛋白降低、乳酸脱氢酶和C反应蛋白升高。动脉血气分析显示中度低氧血症。胸部X线片显示全肺肺炎，CT显示双肺野弥漫性磨玻璃影。肺活检确诊为血管内大B细胞淋巴瘤。原发性肺部表现非常罕见。诊断基于组织病理学和免疫组织化学。
