Pulmonary lymphoma is rare, accounting for < 1% of primary lung cancers. Most primary pulmonary lymphomas (PPL) are low-grade mucosa-associated lymphoid tissue (MALT)-type, and among PPL, diffuse large B-cell lymphoma (DLBCL) is extremely rare. In contrast, there has been an increase in the incidence of DLBCL among patients with autoimmune disorders and recurrent or chronic bacterial infection. A subset of DLBCL has been reported to develop through transformation of preexisting or concurrent MALT. The respiratory symptoms are non-specific, and the chest X-ray findings demonstrate the presence of interstitial and mixed alveolar infiltrates, nodular lesions, and localized homogeneous consolidations; the diagnosis of pulmonary DLBCL is thus challenging and often leads to a misdiagnosis or delayed diagnosis. We herein report a case of DLBCL which was assumed to have arisen from the lesion of chronic atelectasis that was successfully diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). A 74-year-old woman with diffuse bronchiectasis and chronic atelectasis of the left lower lobe suffered from productive cough and high fever. Increased airway filling with mucoid secretion was repeatedly observed within the area of atelectasis with bronchiectasis, and left lower lobe atelectasis developed. Subsequently, the hilar and mediastinal lymph nodes gradually became enlarged, and DLBCL was pathologically confirmed. In the present case, DLBCL was considered to have arisen in the lesion of chronic atelectasis. Physicians should recognize that DLBCL may develop at the site of chronic atelectasis during disease course of diffuse bronchiectasis, and thus DLBCL may be misdiagnosed as superimposed infection of chronic atelectasis.
Methods 612 mothers were recruited to participate in this cross sectional study from 11 community general paediatric practices. Social capital was assessed using the Social Capital Scale (SCS) and mothers' depressive symptoms were assessed using the Centre for Epidemiologic Depression Scale (CESD). The SCS has five factors. The local IRB approved this study. Results About 3/4 of mothers were married or had a live in partner, 2/3 were white, median family income was $30,000, mothers' average years of school was 13 years. The total SCS score and scores for each of the five factors were all significantly inversely correlated (Spearman) with total score and the CESD (p = 0.0001). Total CESD and total SCS (r = -0.275). Belonging to the community factor was slightly stronger (r = -302) than total SCS. While statistically significant, the remaining four factors all had correlations with the total CESD of around -0.2 or less. Conclusions This study found that, beyond mothers' personal social network, a sense of belonging to the community is an important factor associated with mothers' depressive symptoms. Future studies should include longitudinal assessments of social capital and depressive symptoms to understand better the relation among personal social support, community social capital and depressive symptoms over time.
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