Xu Huiting, Xu Kai, Wang Ru, Liu Xiaohua
From the Department of Radiology (HX, RW, XL), Affiliated Hospital of Xuzhou Medical College; and School of Medical Imaging (HX, KX, RW), Xuzhou Medical College, Xuzhou, China.
Medicine (Baltimore). 2015 Jul;94(29):e1210. doi: 10.1097/MD.0000000000001210.
Primary pulmonary diffuse large B-cell lymphoma (PPDLBCL) directly arising from lung tissue is extremely rare. It may usually be misdiagnosed as inflammation including pulmonary tuberculosis, even lung cancer, because its clinical symptoms and signs are often nonspecific. The final diagnosis usually depends on lung biopsy. Herein, we report a case of PPDLBCL and review of diagnosis of this disease, particularly in radiology. A 44-year-old man presented with cough, sputum, and intermittent chest pain for 4 weeks. Multiple radiological examinations showed an irregular mass in the right upper lobe with ground-glass opacities around it and air-filled bronchi in the consolidation. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography-magnetic resonance imaging (MRI) detected positive FDG uptake, and diffusion-weighted imaging indicated abnormal hyperintension in the lesion. Inflammation was suspected, but malignance cannot be excluded. Finally, ultrasound-guided fine-needle aspiration cytology was performed for histological examination and definitive diagnosis yielded lymphomatous cells infiltration in the right upper lobe. This report emphasizes the significance of multimodality radiological examinations. Multimodality imaging contributes to proper diagnosis, staging, and management of lymphomas.
直接起源于肺组织的原发性肺弥漫性大B细胞淋巴瘤（PPDLBCL）极为罕见。它通常可能被误诊为包括肺结核在内的炎症，甚至是肺癌，因为其临床症状和体征往往不具有特异性。最终诊断通常依赖于肺活检。在此，我们报告一例PPDLBCL病例，并对该疾病的诊断进行综述，尤其是在放射学方面。一名44岁男性出现咳嗽、咳痰及间歇性胸痛4周。多项影像学检查显示右上叶有一不规则肿块，其周围有磨玻璃样混浊，实变区内可见充气支气管。氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描-磁共振成像（MRI）检测到FDG摄取阳性，扩散加权成像显示病变处异常高信号。怀疑为炎症，但不能排除恶性肿瘤。最后，进行了超声引导下细针穿刺细胞学检查以进行组织学检查，最终诊断为右上叶淋巴瘤细胞浸润。本报告强调了多模态影像学检查的重要性。多模态成像有助于淋巴瘤的正确诊断、分期及治疗。
