Krishnamurthy Kritika, Kochiyil Jyotsna, Tuda Claudio, Sriganeshan Vathany
From the Department of Pathology and Laboratory Medicine.
Department of Radiology.
Am J Forensic Med Pathol. 2020 Dec;41(4):309-312. doi: 10.1097/PAF.0000000000000586.
In modern medicine, there is an increasing dependence on noninvasive imaging modalities, for diagnosis and management of diseases. Though there are definite advantages to this, they are at times offset by diagnostic pitfalls especially in entities with elusive clinical presentation.Peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS) is an aggressive subtype of T-cell lymphomas that does not meet criteria for a specific subtype. Peripheral T-cell lymphoma usually has varied clinical presentations depending on the site of involvement. Vast majority of PTCL patients present with systemic disease, generalized lymphadenopathy and constitutional symptoms. Pulmonary involvement is relatively rare and is seen in approximately 10% of patients.Here in we highlight a rare case of PTCL, masquerading as pneumonia due to extensive pulmonary involvement that went undiagnosed and was discovered at autopsy. This case of malignant lymphoma of T-cell origin involving the lung, which is very rare, highlights the continued importance of medical autopsies not only as a teaching tool but also as an important adjunct to investigative medicine in uncovering lapses that can subsequently be avoided to improve patient care and decrease mortality.
在现代医学中，对疾病的诊断和管理越来越依赖于非侵入性成像方式。尽管这有明确的优势，但有时会被诊断陷阱所抵消，尤其是在临床表现难以捉摸的疾病中。外周T细胞淋巴瘤，非特指型（PTCL-NOS）是一种侵袭性T细胞淋巴瘤亚型，不符合特定亚型的标准。外周T细胞淋巴瘤通常根据受累部位有不同的临床表现。绝大多数PTCL患者表现为全身性疾病、全身淋巴结肿大和全身症状。肺部受累相对少见，约10%的患者会出现。在此，我们重点介绍一例罕见的PTCL病例，因广泛的肺部受累而伪装成肺炎，生前未被诊断，尸检时才被发现。这例起源于T细胞的恶性淋巴瘤累及肺部的病例非常罕见，凸显了医学尸检持续的重要性，它不仅是一种教学工具，也是调查医学的重要辅助手段，可揭示失误，从而避免失误以改善患者护理并降低死亡率。
