Bae Hyun Jin, Chon Gyu Rak, Kim Dae Jung, Lee Sun Hun, Ahn Jin-Young
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Cheongju St. Mary's Hospital, Cheongju-si, Republic of Korea.
Respir Med Case Rep. 2017 Apr 12;21:108-112. doi: 10.1016/j.rmcr.2017.04.009. eCollection 2017.
A 71-year-old man was admitted to our hospital for dyspnea, which had worsened over a period of more than six months. He was previously diagnosed as having cryptogenic organizing pneumonia, and was treated with steroids in another hospital. He had complained of worsening dyspnea, despite the treatment. We performed video-assisted thoracoscopic surgery because of the high level of lactate dehydrogenase and inconsistency of the usual interstitial pneumonia pattern. Pathologic specimens showed atypical lymphocytes confined to the pulmonary capillaries. On immunohistochemical staining, tumor cells were found positive for CD20, without the T-cell marker. It was consistent with findings of intravascular large B-cell lymphoma. We report this case, which presented with progressive multiple nodules on chest computed tomography.
一名71岁男性因呼吸困难入院，该症状在六个多月的时间里逐渐加重。他之前被诊断为隐源性机化性肺炎，并在另一家医院接受了类固醇治疗。尽管接受了治疗，但他仍抱怨呼吸困难加重。由于乳酸脱氢酶水平较高且不符合常见的间质性肺炎模式，我们进行了电视辅助胸腔镜手术。病理标本显示非典型淋巴细胞局限于肺毛细血管。免疫组织化学染色显示，肿瘤细胞CD20呈阳性，无T细胞标志物。这与血管内大B细胞淋巴瘤的表现一致。我们报告了该病例，其胸部计算机断层扫描显示有进行性多发结节。
