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Low grade pulmonary lymphomatoid granulomatosis with an endobronchial mass.

Kim KH, Park J, Yoo JY, Kim MJ, Kim I, Rhee CK, Lee HY - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: Bronchoscopic biopsy was diagnosed with LYG grade 1.After treatment, the endobronchial mass and lung lesions were completely resolved.However, the patient eventually evolved to malignant lymphoma after 1 year.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Lymphomatoid granulomatosis (LYG) is an angiocentric and angiodestructive neoplastic proliferation of B and T lymphocytes commonly involving the lungs. Epstein-Barr virus is commonly detected in lesional cells. We report a case of a 54-year-old female with underlying monoclonal gammopathy of unknown significance who presented with a 4 week history of dyspnea and cough. Computed tomography scan of the chest showed multiple lung nodules as well as endobronchial narrowing causing atelectasis at the left upper lobe. Bronchoscopic findings revealed obstruction at the lingula segment due to endobronchial mass as a rare presentation. Bronchoscopic biopsy was diagnosed with LYG grade 1. After treatment, the endobronchial mass and lung lesions were completely resolved. However, the patient eventually evolved to malignant lymphoma after 1 year.

No MeSH data available.


Related in: MedlinePlus

Bronchoscopy showing diffused bronchial nodular lesions with hypervascular mucosal changes and luminal narrowing at right upper lobe (A) and left upper lobe lingular division revealing almost near obstruction (B).
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Figure 2: Bronchoscopy showing diffused bronchial nodular lesions with hypervascular mucosal changes and luminal narrowing at right upper lobe (A) and left upper lobe lingular division revealing almost near obstruction (B).

Mentions: Bronchoscopic examination revealed diffuse bronchial nodular lesions with hypervascular mucosal changes and luminal narrowing at both bronchi (Figure 2A). Especially, left upper lobe (LUL) lingula division was almost nearly obstructed due to nodular lesion (Figure 2B). Endobronchial biopsy was performed at lingula division. Histopathologic examination showed infiltration with polymorphic atypical lymphoid cells and histiocytes (Figure 3A). Immunohistochemistry for CD3, CD20 as well as in situ hybridization for EBV were performed. Special stains demonstrated that the atypical population was characterized by many CD3-positive small reactive T cells (Figure 3B) with some scattered large CD20-positive B cells (Figure 3C). In situ hybridization for EBV-encoded RNA revealed a consistent number of EBV-positive large B cells (Figure 3D). This was consistent with a diagnosis of LYG grade 1.


Low grade pulmonary lymphomatoid granulomatosis with an endobronchial mass.

Kim KH, Park J, Yoo JY, Kim MJ, Kim I, Rhee CK, Lee HY - Tuberc Respir Dis (Seoul) (2015)

Bronchoscopy showing diffused bronchial nodular lesions with hypervascular mucosal changes and luminal narrowing at right upper lobe (A) and left upper lobe lingular division revealing almost near obstruction (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388899&req=5

Figure 2: Bronchoscopy showing diffused bronchial nodular lesions with hypervascular mucosal changes and luminal narrowing at right upper lobe (A) and left upper lobe lingular division revealing almost near obstruction (B).
Mentions: Bronchoscopic examination revealed diffuse bronchial nodular lesions with hypervascular mucosal changes and luminal narrowing at both bronchi (Figure 2A). Especially, left upper lobe (LUL) lingula division was almost nearly obstructed due to nodular lesion (Figure 2B). Endobronchial biopsy was performed at lingula division. Histopathologic examination showed infiltration with polymorphic atypical lymphoid cells and histiocytes (Figure 3A). Immunohistochemistry for CD3, CD20 as well as in situ hybridization for EBV were performed. Special stains demonstrated that the atypical population was characterized by many CD3-positive small reactive T cells (Figure 3B) with some scattered large CD20-positive B cells (Figure 3C). In situ hybridization for EBV-encoded RNA revealed a consistent number of EBV-positive large B cells (Figure 3D). This was consistent with a diagnosis of LYG grade 1.

Bottom Line: Bronchoscopic biopsy was diagnosed with LYG grade 1.After treatment, the endobronchial mass and lung lesions were completely resolved.However, the patient eventually evolved to malignant lymphoma after 1 year.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Lymphomatoid granulomatosis (LYG) is an angiocentric and angiodestructive neoplastic proliferation of B and T lymphocytes commonly involving the lungs. Epstein-Barr virus is commonly detected in lesional cells. We report a case of a 54-year-old female with underlying monoclonal gammopathy of unknown significance who presented with a 4 week history of dyspnea and cough. Computed tomography scan of the chest showed multiple lung nodules as well as endobronchial narrowing causing atelectasis at the left upper lobe. Bronchoscopic findings revealed obstruction at the lingula segment due to endobronchial mass as a rare presentation. Bronchoscopic biopsy was diagnosed with LYG grade 1. After treatment, the endobronchial mass and lung lesions were completely resolved. However, the patient eventually evolved to malignant lymphoma after 1 year.

No MeSH data available.


Related in: MedlinePlus