Tanaka Michihiko, Horimasu Yasushi, Kawamoto Kazuma, Edahiro Taro, Yamaguchi Kakuhiro, Sakamoto Shinjiro, Masuda Takeshi, Nakashima Taku, Iwamoto Hiroshi, Fujitaka Kazunori, Hamada Hironobu, Ichinohe Tatsuo, Hattori Noboru
Department of Respiratory Medicine, Hiroshima University Hospital, Japan.
Department of Hematology, Hiroshima University Hospital, Japan.
Respir Med Case Rep. 2024 Sep 26;52:102127. doi: 10.1016/j.rmcr.2024.102127. eCollection 2024.
A 63-year-old Japanese female presented with fever. Computed tomography showed multiple nodules in both lungs. Corticosteroids and antibiotics were administered to treat suspected organizing and bacterial pneumonia, resulting in no improvement and respiratory failure worsened. Surgical lung biopsy revealed infiltration of CD3, CD56, Granzyme B, and EBV-encoded RNA-ISH-positive atypical lymphocytes. She was diagnosed with primary pulmonary extranodal NK/T-cell lymphoma (ENKL) and died two months after diagnosis with only a temporary effectiveness of chemotherapy. We should consider the possibility of ENKL and perform prompt and appropriate biopsy for early diagnosis in cases where empiric therapy is ineffective for suspected pneumonia.
一名63岁的日本女性因发热就诊。计算机断层扫描显示双肺有多个结节。给予皮质类固醇和抗生素治疗疑似机化性肺炎和细菌性肺炎，但病情无改善且呼吸衰竭加重。手术肺活检显示CD3、CD56、颗粒酶B浸润，且EBV编码RNA原位杂交阳性的非典型淋巴细胞浸润。她被诊断为原发性肺结外NK/T细胞淋巴瘤（ENKL），诊断后两个月死亡，化疗仅暂时有效。对于疑似肺炎经验性治疗无效的病例，我们应考虑ENKL的可能性，并及时进行适当活检以早期诊断。
