Migratory pulmonary infiltrates in a patient with COVID-19 and lymphoma

Santana, Alfredo Nicodemos Cruz; Melo, Felipe Xavier de; Xavier, Flávia Caló Aquino; Amado, Verônica Moreira

doi:10.36416/1806-3756/e20200528

Cited by 7 publications

(5 citation statements)

References 10 publications

(10 reference statements)

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“…In particular, two cases of OP were observed in hematologic patients, where chest CT scans showed migratory pulmonary opacities without signs of pulmonary thromboembolism. A presumptive diagnosis of OP was made on the basis of prolonged clinical progression and typical CT findings [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Pneumonia with Migratory Pattern in Agammaglobulinemic Patients: A Report of Two Cases and Review of Literature

et al. 2023

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X-linked agammaglobulinemia (XLA) is a primary immunodeficiency characterized by marked reduction in serum immunoglobulins and early-onset infections. Coronavirus Disease-2019 (COVID-19) pneumonia in immunocompromised patients presents clinical and radiological peculiarities which have not yet been completely understood. Very few cases of agammaglobulinemic patients with COVID-19 have been reported since the beginning of the pandemic in February 2020. We report two cases of migrant COVID-19 pneumonia in XLA patients.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Pneumonia with Migratory Pattern in Agammaglobulinemic Patients: A Report of Two Cases and Review of Literature

et al. 2023

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“…Secondary OP can be caused by various viral infections, including adenovirus, cytomegalovirus, herpes, human immunodeficiency virus, influenza, and Middle East respiratory syndrome coronavirus, perhaps via immune system stimulation by viral antigens. 12 Given the prior findings [9][10][11] that the duration of active SARS-CoV-2 replication was prolonged and migratory pulmonary infiltrates on imaging in patients previously treated with anti-CD20 monoclonal antibodies, such as rituximab, and that radiological features of OP were commonly seen in COVID-19 patients, we assumed that our patient developed SOP to SARS-CoV-2 infection after 120 days of onset.…”

Section: Discussionmentioning

confidence: 93%

“…His serial chest CT revealed rapidly changing migratory pulmonary infiltrates. To our knowledge, precious few cases [9][10][11] have been reported concerning migratory pulmonary infiltrates in rituximab-treated patients with SARS-CoV-2 infection, and this is the first reported case of prolonged COVID-19 with notable migratory pulmonary infiltrates in a patient with previous obinutuzumab therapy.…”

Section: Introductionmentioning

confidence: 79%

Migratory Pulmonary Infiltrates in a B-Cell-Depleted COVID-19 Patient

Zhu,

Xie,

et al. 2023

IDR

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still rampant around the world. Immunocompromised patients are prone to have long-term infection with coronavirus disease 2019 (COVID-19). However, it is difficult to decide on an appropriate treatment for persistent SARS-CoV-2 infection. Case Presentation: We present a case of prolonged SARS-CoV-2 infection in a patient who had undergone B-cell depletion therapy. Chest computed tomography (CT) revealed notable migratory pulmonary infiltrates, and bronchoalveolar lavage fluid was positive for SARS-CoV-2 (day-120). The patient responded well to the combination treatment of antiviral medication, convalescent plasma, and corticosteroid. Conclusion: When chest CT shows migratory pulmonary infiltrates in patients with recent COVID-19, it is necessary to be alert to the possibility of persistent SARS-CoV-2 infection, especially in B-cell-depleted immunocompromised patients. Once the diagnosis is confirmed, repeated antiviral therapy and intravenous convalescent plasma should be considered.

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“…Migratory opacities have been described in several case reports of prolonged SARS-CoV-2 infection in lymphoma patients with available CT findings. The literature review revealed eight cases of lymphoma patients (four follicular lymphoma, one chronic lymphocytic leukemia, one mantle cell lymphoma, one marginal zone lymphoma, and one Hodgkin lymphoma) with migratory opacities [ 8 9 10 14 20 25 26 27 ], which are summarized in Supplementary Table 1 . Except for one follicular lymphoma patient whose treatment was not specified and one Hodgkin lymphoma patient, all six patients had received rituximab or other B-cell depleting agents, as in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Three case reports of COVID-19 patients with lymphoma or chronic lymphocytic leukemia have described “migration” of airspace opacities, in which clearing of preexisting airspace opacities was accompanied by the development of similar-looking opacities in completely different locations [ 8 9 10 ], but they were anecdotal, and detailed radiological and clinical analyses were not available. During our daily practice, we have encountered a similar phenomenon in some patients with hematologic malignancies infected with SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

Migratory Pneumonia in Prolonged SARS-CoV-2 Infection in Patients Treated With B-cell Depletion Therapies for B-cell Lymphoma

Lee

Beck

et al. 2023

Korean J Radiol

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Objective To report the clinical and radiological characteristics of patients with underlying B-cell lymphoma and coronavirus disease 2019 (COVID-19) showing migratory airspace opacities on serial chest computed tomography (CT) with persistent COVID-19 symptoms. Materials and Methods From January 2020 to June 2022, of the 56 patients with underlying hematologic malignancy who had undergone chest CT more than once at our hospital after acquiring COVID-19, seven adult patients (5 female; age range, 37–71 years; median age, 45 years) who showed migratory airspace opacities on chest CT were selected for the analysis of clinical and CT features. Results All patients had been diagnosed with B-cell lymphoma (three diffuse large B-cell lymphoma and four follicular lymphoma) and had received B-cell depleting chemotherapy, including rituximab, within three months prior to COVID-19 diagnosis. The patients underwent a median of 3 CT scans during the follow-up period (median 124 days). All patients showed multifocal patchy peripheral ground glass opacities (GGOs) with basal predominance in the baseline CTs. In all patients, follow-up CTs demonstrated clearing of previous airspace opacities with the development of new peripheral and peribronchial GGO and consolidation in different locations. Throughout the follow-up period, all patients demonstrated prolonged COVID-19 symptoms accompanied by positive polymerase chain reaction results from nasopharyngeal swabs, with cycle threshold values of less than 25. Conclusion COVID-19 patients with B-cell lymphoma who had received B-cell depleting therapy and are experiencing prolonged SARS-CoV-2 infection and persistent symptoms may demonstrate migratory airspace opacities on serial CT, which could be interpreted as ongoing COVID-19 pneumonia.

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Migratory pulmonary infiltrates in a patient with COVID-19 and lymphoma

Cited by 7 publications

References 10 publications

COVID-19 Pneumonia with Migratory Pattern in Agammaglobulinemic Patients: A Report of Two Cases and Review of Literature

COVID-19 Pneumonia with Migratory Pattern in Agammaglobulinemic Patients: A Report of Two Cases and Review of Literature

Migratory Pulmonary Infiltrates in a B-Cell-Depleted COVID-19 Patient

Migratory Pneumonia in Prolonged SARS-CoV-2 Infection in Patients Treated With B-cell Depletion Therapies for B-cell Lymphoma

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