Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Thorac Cancer. 2022 Aug;13(16):2398-2400. doi: 10.1111/1759-7714.14571. Epub 2022 Jul 10.
Cavitary lung lesions found on chest imaging may point to various diseases. These lesions may be caused by numerous etiologies, such as infection, inflammatory diseases, or malignancy. Thus, its etiology may be challenging to differentiate using imaging alone. Differential diagnoses are created using a combination of clinical symptoms, medical history, laboratory results, and physical examination. Primary pulmonary lymphoma and anaplastic large cell lymphoma (ALCL) are rare differentials. Here, we report a case of ALCL that initially presented with back pain, intermittent fever, hemoptysis, hypercalcemia, and bilateral multiple cavitary lung nodules. Because a cavitary pulmonary mass with sustained hypercalcemia is commonly seen in patients with squamous cell carcinomas or pulmonary tuberculosis, patients with ALCL may be misdiagnosed and undergo delayed treatment. This study highlights that ALCL should be considered in patients presenting with a cavitary pulmonary mass and hypercalcemia.
胸部影像学检查发现的空洞性肺病变可能指向各种疾病。这些病变可能由多种病因引起,如感染、炎症性疾病或恶性肿瘤。因此,仅凭影像学检查可能难以区分其病因。鉴别诊断是通过结合临床症状、病史、实验室结果和体格检查来制定的。原发性肺淋巴瘤和间变性大细胞淋巴瘤(ALCL)是罕见的鉴别诊断。在这里,我们报告了一例最初表现为背痛、间歇性发热、咯血、高钙血症和双侧多发性空洞性肺结节的 ALCL 病例。由于伴有持续性高钙血症的空洞性肺肿块在鳞状细胞癌或肺结核患者中很常见,因此 ALCL 患者可能会被误诊并接受延迟治疗。本研究强调,对于出现空洞性肺肿块和高钙血症的患者,应考虑 ALCL。