Granulomatous Lymphocytic Interstitial Lung Disease in Multiple Myeloma

Abstract

An 82-year-old woman complained of recurring cough and shortness of breath and was diagnosed with progressive multiple myeloma (MM). Chest computed tomography (CT) revealed bilateral ground-glass opacity and interlobular septal thickening predominantly in the lower lung zones. Histopathologic findings obtained by a transbronchial lung cryobiopsy (TBLC) revealed alveolitis and granulomas consistent with granulomatous-lymphocytic interstitial lung disease (GLILD). Aggressive chemotherapy for MM contributed to the improvement in respiratory symptoms and abnormal chest CT findings. In cases of MM with lung abnormalities, the possibility of GLILD must be ruled out, and a TBLC should be considered to attain an accurate diagnosis.

Uncommon Causes of Interlobular Septal Thickening on CT Images and Their Distinguishing Features

“…GLILD is a rare disorder characterized by lymphocytic infiltration and the presence of granulomas in the lungs. It is also a complication of common variable immunodeficiency (CVID) [ 51 ]. The clinical features of GLILD range from major symptoms of breathlessness and cough to being asymptomatic.…”