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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

After 8 months of lymphomatoid granulomatosis diagnosis, computed tomography scan of chest showing left upper lobe (LUL) lobar bronchus obstruction and LUL total collapse (A) with bronchoscopy showing total obstruction of LUL bronchus by mass (B).
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Figure 4: After 8 months of lymphomatoid granulomatosis diagnosis, computed tomography scan of chest showing left upper lobe (LUL) lobar bronchus obstruction and LUL total collapse (A) with bronchoscopy showing total obstruction of LUL bronchus by mass (B).

Mentions: After corticosteroid pulse therapy, the patient's symptoms recovered and there was gradual but slow resolution of radiograph findings. After discharge, she was on maintenance corticosteroids. Nevertheless, after 8 months her respiratory symptoms recurred and computed tomography (CT) findings revealed LUL total collapse and follow-up bronchoscopy revealed total obstruction of LUL lingula segment (Figure 4). Cyclophosphamide therapy was started and 1 year later, there was complete regression of endobronchial tumor and atelectasis in LUL as well as multiple lung nodules (Figure 5). In spite of improvement in the lungs, 1 month later on, she developed enlargement of multiple lymph nodes in the neck, mediastinum and abdomen. Neck lymph node excisional biopsy was done and the result confirmed diffuse large B-cell lymphoma. Positron emission tomography CT results showed fludeoxyglucose uptakes in bilateral lower neck, mediastinum, peribronchial, mesentery and retroperitoneum nodes (Figure 6). The patient is receiving chemotherapy (R-CHOP) and is showing partial regression.


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)

After 8 months of lymphomatoid granulomatosis diagnosis, computed tomography scan of chest showing left upper lobe (LUL) lobar bronchus obstruction and LUL total collapse (A) with bronchoscopy showing total obstruction of LUL bronchus by mass (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: After 8 months of lymphomatoid granulomatosis diagnosis, computed tomography scan of chest showing left upper lobe (LUL) lobar bronchus obstruction and LUL total collapse (A) with bronchoscopy showing total obstruction of LUL bronchus by mass (B).
Mentions: After corticosteroid pulse therapy, the patient's symptoms recovered and there was gradual but slow resolution of radiograph findings. After discharge, she was on maintenance corticosteroids. Nevertheless, after 8 months her respiratory symptoms recurred and computed tomography (CT) findings revealed LUL total collapse and follow-up bronchoscopy revealed total obstruction of LUL lingula segment (Figure 4). Cyclophosphamide therapy was started and 1 year later, there was complete regression of endobronchial tumor and atelectasis in LUL as well as multiple lung nodules (Figure 5). In spite of improvement in the lungs, 1 month later on, she developed enlargement of multiple lymph nodes in the neck, mediastinum and abdomen. Neck lymph node excisional biopsy was done and the result confirmed diffuse large B-cell lymphoma. Positron emission tomography CT results showed fludeoxyglucose uptakes in bilateral lower neck, mediastinum, peribronchial, mesentery and retroperitoneum nodes (Figure 6). The patient is receiving chemotherapy (R-CHOP) and is showing partial regression.

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