Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
BMC Pulm Med. 2021 Mar 19;21(1):94. doi: 10.1186/s12890-021-01457-y.
Chronic lymphoproliferative disorder of natural killer cells (CLPD-NK) is an extremely rare haematological disease. To the best of our knowledge, pulmonary infiltration in CLPD-NK has not been reported before. Our case study aimed to present the clinical characteristics, chest computed tomography (CT) findings, and flow cytometry immunophenotyping (FCI) results of an unusual case of migratory pulmonary infiltration in a patient with CLPD-NK.
A 51-year-old female patient was admitted to our hospital on October 8, 2019. Eight months before this visit, she had been diagnosed with pneumonia in a community hospital with 1 month of low-grade fever and had recovered after oral antibiotic administration. During follow-up, the patient presented with persistent peripheral blood (PB) lymphocytosis and ground-glass opacities on lung CT scans without any symptoms and signs or any evidence of infectious, allergic or autoimmunity pulmonary diseases. Abnormal NK cells were identified in the PB, bone marrow and bronchoalveolar lavage fluid (BALF) using FCI in our hospital. Eventually, the patient was diagnosed with pulmonary infiltration of CLPD-NK. The patient had an indolent clinical course without symptoms, hepatosplenomegaly or palpable lymphadenopathy and did not receive any therapy. The patient has remained in a good performance status 13 months after the diagnosis.
Our study described a unique case of pulmonary infiltration in a patient with CLPD-NK. The present case highlights the importance of FCI of the BALF in patients with lymphocytosis and pulmonary shadows to avoid misdiagnosis.
自然杀伤细胞慢性淋巴增殖性疾病（CLPD-NK）是一种极为罕见的血液系统疾病。据我们所知，CLPD-NK 以前从未报道过肺部浸润。我们的病例研究旨在介绍一例 CLPD-NK 患者游走性肺部浸润的临床特征、胸部计算机断层扫描（CT）表现和流式细胞免疫表型（FCI）结果。
一名 51 岁女性患者于 2019 年 10 月 8 日入住我院。在此次就诊前 8 个月，她在社区医院被诊断为肺炎，有 1 个月的低热，并在口服抗生素治疗后康复。在随访期间，患者出现持续的外周血（PB）淋巴细胞增多和肺部 CT 扫描磨玻璃影，但无任何症状和体征，也没有感染、过敏或自身免疫性肺部疾病的证据。我们医院的 FCI 发现 PB、骨髓和支气管肺泡灌洗液（BALF）中存在异常 NK 细胞。最终，患者被诊断为 CLPD-NK 肺部浸润。该患者的临床病程呈惰性，无症状、无肝脾肿大或可触及的淋巴结肿大，也未接受任何治疗。诊断后 13 个月，患者仍保持良好的体能状态。
我们的研究描述了一例 CLPD-NK 患者肺部浸润的独特病例。本病例强调了对淋巴细胞增多和肺部阴影患者进行 BALF FCI 的重要性，以避免误诊。
