A 67-year-old woman with fever, multiple lung opacities, visual impairment and acute respiratory failure

Kawano-Dourado, Letícia; Kawassaki, Alexandre de Melo; Capelozzi, Vera Luíza; Tavares, Marcos Soares; Barbas, Carmen Sílvia Valente

doi:10.1136/thoraxjnl-2011-200573

Cited by 2 publications

(1 citation statement)

References 3 publications

(1 reference statement)

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“…Only a few cases of LYG with acute progressive failure have been reported 3 8 9 13 14. A biopsy could not be performed in most patients, resulting in a fatal clinical course without a definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Acute respiratory failure developing in a patient with lymphomatoid granulomatosis

Nomura,

Yuzawa,

Hiruta

et al. 2023

BMJ Case Rep

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Lymphomatoid granulomatosis (LYG) is a rare B cell lymphoproliferative disorder associated with Epstein-Barr virus infection. LYG diagnosis is often difficult because of non-specific and varied radiological and pathological findings. The lung is the most common organ of LYG occurrence, but extrapulmonary lesions involving the central nervous system, skin, kidneys and liver are observed. A surgical biopsy is often inevitable for LYG diagnosis.We encountered a man in his 50s who presented with progressive dyspnoea. Extrapulmonary lesions were not observed. Although he developed respiratory failure within a short period, a low dose of corticosteroid relieved his symptoms. Video-assisted thoracoscopic lung biopsy revealed grade 1 LYG. The patient was successfully treated with chemotherapy, including rituximab. Only a few cases of LYG with progressive respiratory failure are reported, and most have been diagnosed via autopsy. Our case highlights the importance of performing a surgical lung biopsy at the appropriate time to diagnose LYG.

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Section: Discussionmentioning

confidence: 99%

Acute respiratory failure developing in a patient with lymphomatoid granulomatosis

Nomura,

Yuzawa,

Hiruta

et al. 2023

BMJ Case Rep

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Granulomatose lymphomatoïde

Boysson¹,

Geffray²

2013

La Revue de Médecine Interne

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Lymphomatoid granulomatosis, described in 1972 by Liebow, is a rare, Epstein-Barr virus (EBV)-associated lymphoproliferative disorder, involving the lung, and often the skin or the central nervous system. It could have a systemic course making its diagnosis difficult. Controversy still remains about precise taxonomy and lymphomatoid granulomatosis is classified as a lymphoma, whose severity extends from indolent forms to aggressive large B cell lymphomas. Histology is essential and shows characteristically an inflammatory angiocentric infiltrate, composed with polymorphous mononucleated cells containing a varying number of large atypical CD20-positive B-lymphocytes within a background of numerous small reactive CD3-positive T-lymphocytes, often associated with necrosis. In situ hybridization often shows EBV RNA within atypical B-cells. Atypical large B-lymphocytes proportion and to a lesser degree EBV-positive B-lymphocytes proportion allow to classify the disease (grade I to III) and have a prognostic value. An aggressive form of B lymphoma occurs in 7 to 47% of cases during lymphomatoid granulomatosis course. Moreover, grade III diseases share numerous characteristics of lymphoma and often require chemotherapy. Several conditions mimic lymphomatoid granulomatosis, and include various hematologic malignancies (large B-cells lymphomas, T/NK lymphomas, post-immunodepression lymphoproliferative disorders) or granulomatosis with polyangiitis. The objective of this article is to review the clinical, radiological, histological and therapeutic characteristics of this rare disorder.

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A 67-year-old woman with fever, multiple lung opacities, visual impairment and acute respiratory failure

Cited by 2 publications

References 3 publications

Acute respiratory failure developing in a patient with lymphomatoid granulomatosis

Acute respiratory failure developing in a patient with lymphomatoid granulomatosis

Granulomatose lymphomatoïde

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