Fever, Dry Cough and Exertional Dyspnea: Pulmonary Lymphomatoid Granulomatosis Masquerading as Pneumonia, Granulomatosis with Polyangiitis and Infectious Mononucleosis

Xu, Bin; Liu, Hui; Wang, Bishi; Zhang, Hongwei; Wu, Hao; Jin, Ronghua; Zhang, Yulin

doi:10.2169/internalmedicine.54.4822

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Multiple nodules with or without a cavity and peribronchovascular consolidation are seen not only in LYG but also in primary pulmonary lymphoma 2 3. The nodular lesions that coalesce and cavitate in LYG are similar to those in GPA 3 6. In rare circumstances, LYG may present as solitary nodules with clear margins that mimic a lung cancer nodule,7 peribronchovascular consolidation with an air bronchogram similar to acute bacterial pneumonia and interlobular septal thickening that masquerades as interstitial pneumonia 8 9…”

Section: Discussionmentioning

confidence: 99%

“…It is often challenging to distinguish higher-grade LYG from other EBV-related B cell lymphoproliferative diseases, such as diffuse large B cell lymphoma in which EBV-infected B cells cause pathological damage 11. In contrast, in lower-grade LYG, infiltration of polymorphous polyclonal cells into vessels resembles the presentation in other lung diseases, such as GPA 3 6…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…Primary pulmonary DLBCL is frequently misdiagnosed as pneumonia, TB or lung cancer due to its non-specific clinical symptoms, and definitive diagnosis most often requires invasive lung biopsy ( 5 , 17 ). There has been a report of a patient suffering from pulmonary lymphomatoid granulomatosis who was misdiagnosed as suffering from pulmonary aspergillosis and TB ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B‑cell lymphoma with pulmonary and cerebral involvement: A case report

et al. 2018

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Primary diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma; however, the involvement of the lung and central nervous system (CNS) in patients with DLBCL is rare. Furthermore, patients with DLBCL rarely exhibit specific clinical symptoms, which may delay definitive diagnosis. The present study reports the case of a 42-year-old man suffering from primary DLBCL with concurrent pulmonary and cerebral involvement. The patient suffered from human immunodeficiency virus infection and presented with symptoms including dry cough, thoracalgia, intermittent mild fever and mild headache. Thoracic computed tomography scans revealed multiple pulmonary masses, and brain magnetic resonance imaging scans revealed nodules in the left frontal cortex and bilateral basal ganglia. A percutaneous lung needle biopsy test confirmed the diagnosis of DLBCL. In addition, positron emission tomography revealed the involvement of other parts of the body in DLBCL. The aim of the present study was to present the clinical, radiological and histological characteristics of the patient, which may aid physicians in diagnosing pulmonary and CNS involvement in DLBCL.

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“…The treatment is thus more aggressive and based on polychemotherapy regimens. However, few comparative studies are available, likely due to disease rarity, with the majority of available results deriving from small retrospective reports [11][12][13][14][15][16][17][18]. Treatment regimens are heterogeneous and the choice of the regimen depends on the clinical setting as well as patient fitness.…”

Section: Treatment Of High-grade Diseasesmentioning

confidence: 99%

A Multirefractory Lymphomatoid Granulomatosis Successfully Treated with Gemcitabine as a Single Agent: Case Report and Review of the Literature

J¹,

Bron²,

Meuleman³

et al. 2021

annhematoloncol

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Lymphomatoid Granulomatosis (LYG) is a rare, EBV-driven disease with angiocentric and angiodestructive pleomorphic lymphocytic infiltrates. Pulmonary involvement is frequent and responsible for pulmonary manifestations which may be associated with systemic symptoms. Its rarity makes it difficult to diagnose, and the diagnosis is usually made after several months of investigation. There is no consensus on treatment, which can range from a waitand- see approach to multidrug therapy with allogeneic hematopoietic stem cell transplantation, according to histological grade. The lack of consensus does not help in the management of these patients. We report the case of a patient with a multirefractory LYG, who achieved a Complete Remission (CR) with gemcitabine as single agent salvage treatment.

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Fever, Dry Cough and Exertional Dyspnea: Pulmonary Lymphomatoid Granulomatosis Masquerading as Pneumonia, Granulomatosis with Polyangiitis and Infectious Mononucleosis

Cited by 4 publications

References 8 publications

Acute respiratory failure developing in a patient with lymphomatoid granulomatosis

Acute respiratory failure developing in a patient with lymphomatoid granulomatosis

Diffuse large B‑cell lymphoma with pulmonary and cerebral involvement: A case report

A Multirefractory Lymphomatoid Granulomatosis Successfully Treated with Gemcitabine as a Single Agent: Case Report and Review of the Literature

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