Pulmonary Involvement of Peripheral T-Cell Lymphoma Manifesting as Crazy Paving Pattern

Fraser, Traci; Nagarur, Amulya

doi:10.1080/08998280.2015.11929189

Cited by 6 publications

(4 citation statements)

References 10 publications

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“… 23 , 24 Lung disease in PTCL-NOS has been radiographically described as diffuse ground-glass opacities, 24 mass-like consolidation, 25 pulmonary nodules, 26 and/or an indolent progression of subacute to chronic ILD. 24 , 27 - 30 Our patient also had mediastinal lymph node enlargement, which is more commonly described for Hodgkin’s lymphoma rather than non-Hodgkin’s lymphomas. 28 Despite these varied presentations, an acute and fulminant respiratory failure (ARDS) from PTCL is an exceedingly rare occurrence.…”

Section: Discussionmentioning

confidence: 62%

An Unusual Suspect Causing Hypoxemic Respiratory Failure

Aqeel

Batdorf

Olteanu

et al. 2017

Journal of Investigative Medicine High Impact Case Reports

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Introduction: Antisynthetase syndrome (ASS) is characterized by the presence of anti-Jo-1 antibodies in conjunction with clinical findings of fever, polymyositis-dermatomyositis, and interstitial lung disease (ILD). Inflammatory myopathies carry a high risk of malignancy, but this association is less well outlined in ASS. We present the case of a patient with ASS who developed non-Hodgkin’s lymphoma with acute hypoxemic respiratory failure. Case Presentation: A 44-year-old female with ASS presented with acute hypoxemic respiratory failure. She was empirically treated with broad-spectrum antibiotics for a health care–associated pneumonia; however, she failed to improve. Chest computed tomography revealed extensive bilateral ground glass opacities as well as extensive mediastinal and axillary lymphadenopathy. Infectious workup was negative. A surgical lung biopsy revealed peripheral T-cell lymphoma (PTCL). The patient was started on chemotherapy with complete resolution of hypoxemic respiratory failure. Conclusions: Malignancy is very rare in the setting of ASS; and our case illustrates the unique presentation of PTCL in ASS. In addition, lung involvement in PTCL is variable (incidence ranging from 8% to 20%); and in this case, bilateral multifocal consolidation was biopsied and proven to be PTCL involving the lungs. This case highlights the rare noninfectious conditions that can present as acute hypoxemic respiratory failure in the setting of ASS.

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Section: Discussionmentioning

confidence: 62%

An Unusual Suspect Causing Hypoxemic Respiratory Failure

Aqeel

Batdorf

Olteanu

et al. 2017

Journal of Investigative Medicine High Impact Case Reports

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“…Of these 16 patients, 7 had a diagnosis of bronchioalveolar cell carcinomas making it the most common form of lung malignancy presenting as a ‘crazy-paving’ pattern. [ 2 3 5 - 9 ] Five had T-Cell lymphoma,[ 10 11 ] two melanomas,[ 4 8 ] and one patient each with AIDS-related Kaposi sarcoma[ 12 ] and lymphangitis carcinomatosis. [ 3 ] Information regarding unilateral/bilateral presentation was available in 12 patients.…”

Section: Discussionmentioning

confidence: 99%

Unilateral ‘Crazy-Paving’ pattern: An exceptional presentation of squamous cell carcinoma of the lung

Shah

Banday

Khan

et al. 2022

Journal of Family Medicine and Primary Care

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A BSTRACT The ‘crazy-paving’ pattern on high resolution computed tomography (HRCT) is a distinct imaging appearance that is still considered to be a radiological hallmark of pulmonary alveolar proteinosis. However, since its first description about three decades ago, more than 40 different clinical entities presenting as ‘crazy-paving’ patterns have been documented. This rather remarkable but uncommon imaging appearance is now considered to be a non-specific manifestation. A 62-year-old male referred for evaluation of productive cough, breathlessness and fever presented with ‘crazy-paving’ pattern on HRCT. Endobronchial biopsy done on presentation was consistent with the diagnosis of squamous cell carcinoma. This report highlights this atypical presentation of squamous cell carcinoma of the lung and adds to the increasing list of clinical entities presenting as a ‘crazy-paving’ pattern. To our knowledge, squamous cell carcinoma presenting as a ‘crazy-paving’ pattern on HRCT is yet to be documented.

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“…Fu et al (2016) reported a rare case of pneumothorax as first manifestation of PTCL [14]. Three case reports exist concerning crazy paving pattern of PTCL with lung involvement [[15], [16], [17]]. Recently, Aqeel et al reported a rare case of acute respiratory failure in the setting of antisynthetase syndrome (ASS) in a patient with PTCL where the chest CT revealed extensive bilateral ground glass opacities [18].…”

Section: Discussionmentioning

confidence: 99%

Crazy paving pattern as a rare radiological manifestation of peripheral T-cell lymphoma (PTCL) with lung involvement: A case report

Gomatou

Tzilas

Kourti

et al. 2018

Respiratory Medicine Case Reports

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We report on a 70-year old woman with dyspnea, systemic lymphadenopathy and abnormal chest computed tomography (CT) findings. A complete laboratory testing as well as mediastinal tissue sampling via Endobronchial Ultrasound (EBUS)-guided Transbronchial Needle Biopsy (TBNB) did not reveal a definite diagnosis. After experiencing acute respiratory failure which led to intensive care unit, the patient underwent a cervical lymph node biopsy which revealed peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). A CT-guided trans-thoracic lung biopsy was performed that showed involvement of the lung parenchyma in the context of PTCL-NOS. Lung involvement is a rare extra-nodal manifestation of PTCL. The imaging patterns of this lymphoma have not been well described. We conclude that the finding of crazy paving pattern is a rare manifestation of this disease. In patients with pre-existing lymphoma, lung involvement should be included in the differential due to high pre-test probability.

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Pulmonary Involvement of Peripheral T-Cell Lymphoma Manifesting as Crazy Paving Pattern

Cited by 6 publications

References 10 publications

An Unusual Suspect Causing Hypoxemic Respiratory Failure

An Unusual Suspect Causing Hypoxemic Respiratory Failure

Unilateral ‘Crazy-Paving’ pattern: An exceptional presentation of squamous cell carcinoma of the lung

Crazy paving pattern as a rare radiological manifestation of peripheral T-cell lymphoma (PTCL) with lung involvement: A case report

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