Immunoblastic Lymphadenopathy Presenting as Pulmonary Interstitial Fibrosis

Asher, Ron; Burgher, Louis W.; Feagler, John R.

doi:10.1001/jama.1977.03270490051028

Cited by 11 publications

(3 citation statements)

References 4 publications

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“…I hriability oj histologic findings in patients with AlLU + IL: Multiple sections were available in all 42 patients; in 28, it could not be ascertained whether these sections were derived from one or Vol. 41 With admixture of lymphoid cells of inter-4 mediate size as well as typical and atypical plasma cells 5) Combinations of the above features: 23 Clusters and islands (7) Clusters and clear cells (2) Clusters, islands and clear cells (5) Clusters, islands and diffuse areas (1) Clusters and diffuse areas (4) Islands and clear cells (2) Islands and diffuse areas (2) TOTAL (42) *This group includes six patients whose first biopsy showed AILD only, and whose second biopsy showed AILD + IL. Only the morphologic features of the second biopsy are included here.…”

Section: Clinicalmentioning

confidence: 99%

Malignant lymphoma arising in angio-immunoblastic lymphadenopathy

Nathwani

Rappaport²,

Moran

et al. 1978

Cancer

246

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This study is based upon 48 patients with angio-immunoblastic lymphadenopathy and 36 patients whose lymph nodes revealed, in addition to angio-immunoblastic lymphadenopathy (AILD) , histologic features interpreted as malignant lymphoma of the immunoblastic type in the diagnostic biopsy.Progression into immunoblastic lymphoma (IL) w a s observed in 35%, or eight, of the 23 patients with AILD in whom follow-up biopsies or autopsy were performed. Multiple clusters or islands of compactly arranged large lymphoid cells constituted the initial histologic evidence of IL. Subsequent tissue examination revealed progression of the disease in the form of diffuse replacement of lymph nodes by the neoplastic cellular proliferation. No significant differences in the past history, clinical or laboratory findings were observed between the patients with AILD and those whose lymph node biopsies were interpreted as AILD + IL. These two groups differed greatly, however, with respect to rate of complete remission following; either prednisone o r chemotherapy, or both (63% for AILD vs. 26% for AILD + IL.; p = 0.01); median survival (35 months for AILD vs. six months for AILD + IL; p = 0.0004); incidence of malignant lymphoma at autopsy (20% for AILD vs. 82% for ALLD + IL; p < 0.005); and the finding of extranodal malignant lymphoma at autopsy (10% in AILD vs.64% in AILD + IL; p < 0.025). In the AILD group, median survival of patients who had complete remission after prednisone was significantly longer than that of patients who had partial or no remissions ( p = 0.02) and the same was true for patients who were given chemotherapy (p < 0.003). In the AILD + IL group, a similar difference in the median survival was observed in patients treated with chemotherapy ( p < 0.007), but not in those treated with prednisone (p = 0.31).C a n~~r 41578-606, 1978.NGIO-IMMUNOBLASTIC LYMPHADENOPATHY maglobulinemia and Coombs' positive hemolytic A (AILD)'s~'4 or immunoblastic lymphade-anemia are frequently present. The lymph nodes nopathy" is a systemic disease clinically charac-in AILD reveal a polymorphic picture consisting terized by fever, generalized lymphadenopathy of a proliferation of small vessels, immunoand hepatosplenomegaly. Polyclonal hypergam-blasts* and plasma cells. Similar clinical and From the

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Section: Clinicalmentioning

confidence: 99%

Malignant lymphoma arising in angio-immunoblastic lymphadenopathy

Nathwani

Rappaport²,

Moran

et al. 1978

Cancer

246

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“…A conventional report stated that imaging findings varied. Pulmonary involvement was observed in four previous cases 3–5 . To our knowledge, this is the first case that led to a diagnosis of AITL with pulmonary infiltration using BAL.…”

Section: Discussionmentioning

confidence: 57%

“…Pulmonary involvement was observed in four previous cases. 3 , 4 , 5 To our knowledge, this is the first case that led to a diagnosis of AITL with pulmonary infiltration using BAL. In the present case, we performed BAL twice (Table 2 ).…”

Section: Discussionmentioning

confidence: 76%

Use of bronchoalveolar lavage in diagnosing angioimmunoblastic T‐cell lymphoma: A case report

Yamamoto

Takamura

Ishida

et al. 2022

Respirology Case Reports

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Angioimmunoblastic T‐cell lymphoma (AITL) is a type of peripheral T‐cell tumour that belongs to the group of non‐Hodgkin's lymphomas. Pulmonary lesions can be found in 7%–10% of AITL cases. Imaging findings of the lungs varied; however, immunoblastic infiltration in the lungs is rare. Our patient was a 73‐year‐old man who received repeated chemotherapy for AITL. Fourth‐line therapy using romidepsin controlled the illness, but the patient was hospitalized for dyspnoea and an infiltrative shadow. We performed bronchoalveolar lavage (BAL), and the culture was positive for Haemophilus influenzae . The patient was initially discharged with antibiotic therapy, but hospitalized again. Antibiotics were ineffective and the patient required mechanical ventilation. BAL was performed again, after which fluid cytology revealed immunoblast‐like atypical cells. Therefore, the patient was diagnosed with pulmonary infiltration due to AITL. Steroid therapy proved ineffective, and the patient died. BAL was used to effectively diagnose pulmonary AITL infiltration.

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Angioimmunoblastic lymphadenopathy: Clinical spectrum of disease

Schauer

Straus

Clarkson

et al. 1981

Cancer

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The clinical features of 13 patients with angioimmunoblastic lymphadenopathy were analyzed to determine prognostic factors and response to therapy. Eleven patients presented with sudden onset of fever, weight loss, generalized lymphadenopathy, and hepatosplenomegaly. Laboratory features included autoimmune hemolytic anemia and polyclonal hypergammaglobulinemia. Pulmonary involvement was seen in six cases and skin rash in four. Two patients had localized lymphadenopathy without systemic symptoms. Both are alive at 5.5 and 2.5 years, respectively, after diagnosis, although the latter patient has required intermittent prednisone for recurrent lymphadenopathy. An additional patient is alive on treatment for months following diagnosis. The remaining ten have died, nine of sepsis and one of cerebral hemorrhage. The immunosuppression and myelosuppression of combination chemotherapy may have hastened their deaths. An individualized, conservative treatment approach is recommended.

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Immunoblastic Lymphadenopathy Presenting as Pulmonary Interstitial Fibrosis

Cited by 11 publications

References 4 publications

Malignant lymphoma arising in angio-immunoblastic lymphadenopathy

Malignant lymphoma arising in angio-immunoblastic lymphadenopathy

Use of bronchoalveolar lavage in diagnosing angioimmunoblastic T‐cell lymphoma: A case report

Angioimmunoblastic lymphadenopathy: Clinical spectrum of disease

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