Department of Paediatrics, Division of Paediatric Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.
Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.
Natl Med J India. 2021 Nov-Dec;34(6):343-346. doi: 10.25259/NMJI_174_20.
Primary endobronchial presentation of anaplastic large cell lymphoma is rare in the paediatric age group. We present a 12-year-old boy with breathlessness, fever, cough and weight loss, who was misdiagnosed as a case of tuberculosis and started on antitubercular therapy, which showed no improvement. Chest X-ray showed a completely opacified left hemithorax and chest computed tomography revealed a mass encircling the left main bronchus with collapse- consolidation of the left lung. Fibreoptic bronchoscopy revealed a growth in the left main bronchus. Subsequently, fine-needle aspiration cytology and biopsy from the mass confirmed it to be a malignancy consistent with anaplastic large cell lymphoma. Metastatic work-up revealed no other sites of involvement. Chemotherapy resulted in rapid and complete regression of the tumour. No evidence of local or distant recurrence was reported after 18 months of follow-up. Clinicians and pathologists should be aware of this presentation as prompt diagnosis and treatment can give promising results. This case highlights the importance of timely tissue diagnosis in patients with non-resolving pyrexia and organ lesions on imaging.
原发性支气管内间变性大细胞淋巴瘤在儿科中较为少见。我们报告了一例 12 岁男孩,其出现呼吸困难、发热、咳嗽和体重减轻,最初误诊为肺结核,并开始接受抗结核治疗,但未见改善。胸部 X 线显示左半胸完全不透明,胸部计算机断层扫描显示肿块环绕左主支气管,左肺塌陷实变。纤维支气管镜检查显示左主支气管有生长。随后,对肿块进行的细针抽吸细胞学和活检证实为恶性肿瘤,符合间变性大细胞淋巴瘤。转移情况检查未发现其他受累部位。化疗使肿瘤迅速完全消退。18 个月的随访后,未报告局部或远处复发的证据。临床医生和病理科医生应该意识到这种表现,因为及时诊断和治疗可以带来有希望的结果。本病例强调了在影像学上有持续发热和器官病变的患者中及时进行组织诊断的重要性。