de Campos Fernando Peixoto Ferraz, Felipe-Silva Aloísio, Zerbini Maria Claudia Nogueira, Martines João Augusto Dos Santos
Department of Internal Medicine - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Autops Case Rep. 2013 Dec 31;3(4):29-36. doi: 10.4322/acr.2013.036. eCollection 2013 Oct-Dec.
Primary lung lymphoma is a rare entity accounting for approximately 0.3% of all primary neoplasia of the lung and includes diffuse large B-cell lymphoma (DLBL) and lymphomatoid granulomatosis (LYG). Considering that clinical features may be similar, whereas epidemiology, morphology, and radiological features are different, the authors report a case of a middle-aged man who presented multiple pulmonary nodules in the lower lobes and ground-glass opacities scattered bilaterally on computed tomography. Clinically, he presented a consumptive syndrome with respiratory failure and pleurisy, which progressed until death. The autopsy findings were consistent with lymphomatoid granulomatosis (LYG) grade 3/ diffuse large B-cell lymphoma (DLBL). The authors call attention to the difficulty of establishing an accurate diagnosis, mainly when the demonstration of EBV-infected atypical B-cells fails.
原发性肺淋巴瘤是一种罕见的疾病，约占所有原发性肺肿瘤的0.3%，包括弥漫性大B细胞淋巴瘤（DLBL）和淋巴瘤样肉芽肿病（LYG）。鉴于临床特征可能相似，而流行病学、形态学和放射学特征不同，作者报告了一例中年男性病例，该患者在计算机断层扫描中显示下叶有多个肺结节，双侧散在磨玻璃影。临床上，他表现为消耗综合征伴呼吸衰竭和胸膜炎，病情进展直至死亡。尸检结果符合3级淋巴瘤样肉芽肿病（LYG）/弥漫性大B细胞淋巴瘤（DLBL）。作者提醒注意准确诊断的困难，主要是在未能证实EBV感染的非典型B细胞时。
