Sawant Abhijeet Dharmaji, Patil Vijayraj S, Gugalia Pranjal M, Kumar Rajiv, Jiwnani Sabita, Karimundackal George, Pramesh C S
Department of Thoracic Oncosurgery, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Lung India. 2018 Jan-Feb;35(1):66-69. doi: 10.4103/0970-2113.221727.
A 15-year-old boy presented to us with a 4-month history of fever with worsening dyspnea since 1 month. His contrast-enhanced computed tomography scan of the thorax showed bilateral endobronchial lesions with complete collapse-consolidation of the left lung and partial collapse of the right lower lobe. His fiberoptic bronchoscopy guided biopsy had been reported in outside hospital as a neuroendocrine tumor. Due to worsening breathlessness, he had to be intubated. We repeated the endobronchial biopsy and combined with outside slides and blocks, was diagnosed to have an anaplastic lymphoma kinase-1 positive anaplastic large cell lymphoma (ALCL). We started the patient on chemotherapy to which he had a dramatic response radiologically and clinically. ALCL presenting as endobronchial mass is an extremely rare occurrence and it presenting with bilateral endobronchial masses has not been reported yet in literature. Pathologists and clinicians should be aware of this presentation as prompt diagnosis and treatment give promising results.
一名15岁男孩前来就诊,发热4个月,近1个月呼吸困难加重。他的胸部增强计算机断层扫描显示双侧支气管内病变,左肺完全实变,右肺下叶部分实变。他在外院进行的纤维支气管镜引导下活检报告为神经内分泌肿瘤。由于呼吸困难加重,他不得不接受插管。我们再次进行了支气管内活检,并结合外院的切片和组织块,诊断为间变性淋巴瘤激酶-1阳性间变性大细胞淋巴瘤(ALCL)。我们开始对该患者进行化疗,他在影像学和临床上都有显著反应。以支气管内肿块形式出现的ALCL极为罕见,而以双侧支气管内肿块形式出现的情况在文献中尚未见报道。病理学家和临床医生应注意这种表现,因为及时诊断和治疗会带来良好的结果。