Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan.
Department of Radiology, Kurume University School of Medicine, Japan.
Intern Med. 2023 Feb 1;62(3):439-444. doi: 10.2169/internalmedicine.9758-22. Epub 2022 Jul 14.
An 82-year-old woman complained of recurring cough and shortness of breath and was diagnosed with progressive multiple myeloma (MM). Chest computed tomography (CT) revealed bilateral ground-glass opacity and interlobular septal thickening predominantly in the lower lung zones. Histopathologic findings obtained by a transbronchial lung cryobiopsy (TBLC) revealed alveolitis and granulomas consistent with granulomatous-lymphocytic interstitial lung disease (GLILD). Aggressive chemotherapy for MM contributed to the improvement in respiratory symptoms and abnormal chest CT findings. In cases of MM with lung abnormalities, the possibility of GLILD must be ruled out, and a TBLC should be considered to attain an accurate diagnosis.
一位 82 岁女性因反复咳嗽和呼吸急促而就诊,并被诊断为进行性多发性骨髓瘤(MM)。胸部计算机断层扫描(CT)显示双肺磨玻璃影和小叶间隔增厚,主要位于下肺区。经支气管肺冷冻活检(TBLC)获得的组织病理学检查结果显示,间质性肺病符合肺泡炎和肉芽肿,为肉芽肿性淋巴细胞性间质性肺病(GLILD)。MM 的强化化疗有助于改善呼吸症状和异常的胸部 CT 发现。对于 MM 合并肺部异常的患者,必须排除 GLILD 的可能,应考虑进行 TBLC 以获得准确的诊断。