A 75-Year-Old Woman With Dyspnea and a Sore Throat

A rare cause of fever and PET‐positive nodules in the lungs

“…LYG is a misnomer coined by Liebow in 1972 (2) actually designating an EBV‐driven lymphoproliferative disorder with different aggressiveness ranging from low‐grade to high‐grade angiocentric lymphoma likely secondary to a defective immune response to EBV (1, 3‐5). LYG generally occurs in middle‐aged patients (range 2–85 years) with systemic symptoms mimicking infections (especially tuberculosis), vasculitides (Wegener's granulomatosis in particular) or malignancies, and correct diagnosis is frequently delayed, requiring a mean time of 8.5 months from initial symptoms (6, 7). When LYG is restricted to lungs, fever is the main and often unique symptom, followed by general malaise, weight loss and arthralgia, but clinical manifestations are mainly organ‐related (skin, central nervous system, kidney and liver in primis ).…”

“…Patients with LYG should be investigated for alterations of cytotoxic T‐cell function, since a significant association between LYG and immunodeficiencies has been well‐demonstrated (i.e. AIDS, Wiskott‐Aldrich, post‐transplantation, collagen‐vascular diseases treated with methotrexate, sarcoidosis, hematologic and solid malignancies, chronic liver and cutaneous diseases and medications) (6, 7). Interestingly, Yamashita et al.…”

“…Based on the number of EBV‐positive large B‐cell counted per high‐power field, LYG is graded on three grades. Spontaneous remission or waxing‐and‐waning course has been reported in grade 1 LYG, while grade 2 and 3 LYG are basically a variant of T‐cell‐rich hystiocyte‐rich large B‐cell lymphoma, mortality ranges from 50% to 90% with an overall median survival of 14 months (6, 7). No standard therapies are available now for patients with LYG.…”

Lymphoma of the Base of the Tongue: An Incidental Finding on the Preoperative Workup for a Spine Surgery

“…Lymphoma of the tongue is very rare and accounts for 1% of all malignant tumors of the oral cavity [1-5]. We present a 73 year-old Caucasian man with history of hypertension, chronic obstructive pulmonary disease, and hyperlipidemia who presented in 2008 because of weakness and was ambulating using a walker.…”

“…This case illustrates the importance of performing laryngoscopy in elderly patients during the preoperative workup for any major surgery if they complain of sore throat and shortness of breath with a lifelong history of smoking [1]. Unfortunately, we read our patients obituary in the local newspaper eight months later.…”