Turan O, Turan P A, Uyaroğlu M A, Polat F, Çalli A O
Chest diseases Department, Izmir Katip Celebi University Atatürk Training and Research Hospital, Izmir, Turkey.
Chest diseases Department, Menemen State Hospital, Izmir, Turkey.
Curr Health Sci J. 2019 Oct-Dec;45(4):425-428. doi: 10.12865/CHSJ.45.04.13. Epub 2019 Dec 30.
A 20-year-old female patient was admitted to hospital with complaints of chest and back pain in September 2018. There was a cavitary lesion in the upper zone of the left lung in the chest X-ray. Thorax CT revealed an irregular contoured and shaped mass with 87x67x79 mm sizes, in the upper lobe of the left lung lying to paramediastinal area. Since there was a doubt about malignancy, positron emission tomography (PET) was performed; there was a cavitary lesion in the left upper lobe with high FDG uptake (SUVmax: 23.2). Bronchoscopic examination revealed an endobronchial lesion with nearly complete occlusion in the apicoposterior segment of the left upper lobe. Bronchoalveolar lavage (BAL) performed in this session for acid-fast bacilli (AFB) was negative. The patient was diagnosed as primary pulmonary diffuse large B-cell lymphoma (DLBCL) by histopathological and immunohistochemical evaluation of endobronchial biopsy specimens. Following the final diagnosis of Bronchus-Associated Lymphoid Tissue Lymphoma (BALTOMA), the patient was referred to the department of haematology, and chemotherapy was planned for therapy. Since DLBCL is extremely rare, and uncommonly presenting with an endobronchial lesion, we want to present this patient as the youngest adult case of primary endobronchial BALT lymphoma in the literature.
一名20岁女性患者于2018年9月因胸痛和背痛入院。胸部X线检查显示左肺上叶有空洞性病变。胸部CT显示在左肺上叶靠近纵隔旁区域有一个大小为87×67×79 mm、轮廓和形状不规则的肿块。由于怀疑为恶性肿瘤，进行了正电子发射断层扫描（PET）；左上叶有空洞性病变，FDG摄取高（SUVmax：23.2）。支气管镜检查显示左上叶尖后段有一个几乎完全阻塞的支气管内病变。本次为检测抗酸杆菌（AFB）进行的支气管肺泡灌洗（BAL）结果为阴性。通过对支气管内活检标本进行组织病理学和免疫组织化学评估，该患者被诊断为原发性肺弥漫性大B细胞淋巴瘤（DLBCL）。在最终诊断为支气管相关淋巴组织淋巴瘤（BALTOMA）后，该患者被转诊至血液科，并计划进行化疗。由于DLBCL极为罕见，且很少以支气管内病变形式出现，我们想将该患者作为文献中最年轻的原发性支气管内BALT淋巴瘤成年病例进行展示。
