[Rapidly progressive pulmonary malignant perivascular epithelioid cell tumor: a case report and literature review]

Objective: To analyze the pathogenesis, clinical features, diagnosis and differential diagnosis of primary perivascular epithelioid cell tumor(PEComa). Methods: The clinical features, auxiliary examinations and diagnosis of a case with rapidly progressive pulmonary malignant PEComa were reported and the related literatures were reviewed.The literature review was carried out respectively in Wanfang Data, CNKI and PubMed from Jan. 1975 to Jul. 2015 with "pulmonary malignant perivascular epithelioid cell tumor" and "PEComa" being the search terms. Results: A 50 year-old female patient was admitted to the hospital on September 4, 2014 because of cough and dyspnea for 60 days, hemoptysis for 40 days and fever for 7 days.Chest CT scan showed diffuse small nodules with infiltrative border and multiple pure and mixed ground-glass opacity. Transbronchial lung biopsy (TBLB) was performed and the pathological study confirmed the diagnosis of primary pulmonary malignant PEComa. The patient declined further specific therapy, but followed by rapidly progressive respiratory failure, and died two weeks after the diagnosis. A total of 8 literatures were retrieved from Wanfang Data, CNKI and PubMed and all of them were case reports.There were 3 male and 5 female patients, aging from 50 to 79 years.Radiographically, the previously reported cases presented as round and well-circumscribed masses with or without multiple nodules in both lungs. The symptoms had no specificity. Conclusions: Pulmonary malignant PEComa is a rare disease.It is easily misdiagnosed because of non-specific clinical and imaging manifestations.The final diagnosis depends on pathological biopsy.TBLB is an effective diagnostic method.

A HuR/TGF-β1 feedback circuit regulates airway remodeling in airway smooth muscle cells

Background

Asthma is a worldwide health burden with an alarming prevalence. For years, asthma-associated airway injury remains elusive. Transforming growth factor β1 (TGF-β1) is a pleiotropic cytokine that has been shown to be involved in the synthesis of the matrix molecules associated with airway remodeling. Human antigen R (HuR), the member of the Hu RNA-binding protein family, can bind to a subset of short-lived mRNAs in their 3′ untranslated regions (UTR). However, the functional roles and relevant signaling pathways of HuR in airway remodeling have not been well illustrated. Thus, we aim to explore the relationship between HuR and TGF-β1 in platelet derived growth factor(PDGF)-induced airway smooth muscle (ASM) cells and asthmatic animal.

Methods

Cultured human ASM cells were stimulated by PDGF for 0, 6, 12 and 24 h. Western blotting, RT-PCR and immunofluoresence were used to detect the expression of HuR, TGF-β1, α-smooth muscle actins (α-SMA) and collagen type I (Col-I). Then knockdown of HuR, flow cytomerty was used to detect the morphological change and western blotting for functionally change of ASM cells. Furthermore, the interference of TGF-β1 and exogenous TGF-β1 were implemented to testify the influence on HuR. A murine OVA-driven allergic model based on sensitization and challenge was developed. The inflammatory response was measured by bronchoalveolar lavage fluid (BALF), airway damage was analyzed by hematoxylin and eosin staining, airway remodeling was assessed by sirius red staining and periodic acid-schiff staining, the expression level of HuR, TGF-β1 and α-SMA were measured by RT-PCR, western blotting and immunohistochemistry.

Results

Here, we found that PDGF elevated HuR expression both at mRNA and protein level in cultured ASM cells at a time-dependent manner, which was simultaneously accompanied by the enhanced expression of TGF-β1, α-SMA and Col-I. Further study revealed that the knockdown of HuR significantly increased the apoptosis of ASM cells and dampened TGF-β1, Col-I and α-SMA expression. However, interfering TGF-β1 with siRNA or extra addition of TGF-β1, HuR could restore its production as well as Col-I. Compared with normal mice stimulating with PBS, OVA-induced mice owned high amount of inflammatory cells, such as eosinophils, lymphocytes and neutrophils except macrophages. HE staining showed accumulation of inflammatory cells surrounding bronchiole and sirius red staining distinguished collagen type I and III deposition around the bronchiole. Higher abundance of HuR, TGF-β1 and α-SMA were verified in OVA-induced mice than PBS-induced mice by RT-PCR, western blotting and immunohistochemistry.

Conclusions

A HuR/TGF-β1 feedback circuit was established to regulate airway remodeling in vivo and in vitro and targeting this feedback has considerable potential for the intervention of asthma.

CHKA mediates the poor prognosis of lung adenocarcinoma and acts as a prognostic indicator

Choline kinase α (CHKA), the enzyme that converts choline to phosphocholine, has been studied in human carcinogenesis widely. However, the expression and underlying clinicopathological characteristics of CHKA in lung adenocarcinoma remains elusive. In the present study, a tissue microarray of 119 pairs of lung adenocarcinoma samples and corresponding adjacent normal mucosae was used to analysis CHKA expression by immunohistochemistry, and CHKA was observed to exhibit enhanced expression in lung adenocarcinoma tissues. Elevated CHKA expression in lung adenocarcinoma tissues at the gene and protein level was observed. The levels of CHKA expression were closely associated with the poor prognosis status of lung adenocarcinoma patients. Furthermore, certain clinicopathological characteristics such as tumor diameter and differentiation were observed to be significant in those lung adenocarcinoma patients who displayed enhanced CHKA expression. The analysis of CHKA expression could provide a more precise way to predict the prognosis of lung adenocarcinoma patients. Collectively, the present study revealed a novel biomarker in lung adenocarcinoma, and indicated that CHKA may be a promising prognostic marker and therapeutic target for lung adenocarcinoma.

Tracheobronchopathia Osteochondroplastica: Two Cases Reports and Review of Literature

Tracheobronchopathia osteochondroplastica (TO) is a relatively rare and benign disease of unknown etiology that is characterized by the accumulation of diffuse cartilaginous and osseous nodules protruding into the anterolateral walls of the trachea and bronchus. However, TO is easy to ignore or misdiagnose due to its nonspecific clinical manifestation. A chest computed tomography (CT) scan with a fiber bronchoscope and pathological biopsy shows the clinical features supporting the ultimate diagnosis.Here, we report 2 misdiagnosed cases of TO and review the literature to further define the diagnosis for clinicians. The first case was a 34-year-old male admitted to the hospital because of recurrent cough and intermittent fever for 10 years. CT scans showed irregular stenosis of the main bronchus and bronchofibroscope showed multiple nodules producing into the lumen. He was initially misdiagnosed of bronchial tuberculosis and received antitubercular agents for nearly half year. Symptoms got no relief and another bronchofibroscope with biopsy tests in our hospital exactly diagnosed of TO. Symptoms were significantly relieved after receiving budesonide associated with antibiotics, etc. Another case was a 46-year-old woman presenting with a history of repeated hoarseness for 8 years and a 2-month exacerbation. She underwent an electronic laryngoscopy 3 times and was diagnosed of laryngitis. Symptoms got no relief after antiinflammatory. CT scan indicated variable degrees of stenosis and calcification of the distal trachea and main bronchi and bronchofibroscope showed dozens of white nodules extruding into the lumen. Histopathologic findings revealed the ultimate diagnosis of TO and antiinflammatories, spasm relievers, and inhaled corticosteroids, showed apparent effects.Poor specificity of TO is observed in clinical manifestation and laboratory inspection. However, a CT scan associated with a bronchoscopy and histopathologic examination greatly contributes to a definitive diagnosis. No specific treatments are recommended, except treatments to alleviate symptoms. Thus, it is of great importance to consider TO when facing unsolved respiratory or external respiratory symptoms to improve the quality of life.

Acute myocardial infarction following erlotinib treatment for NSCLC: A case report

Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor, is an oral targeted anticancer drug that is used to treat non-small cell lung cancer (NSCLC). Previous studies have confirmed that erlotinib is safe and is well-tolerated by patients. The most common adverse reactions observed following erlotinib treatment include a rash and mild diarrhea. In the current study, the first case of acute myocardial infarction following one month of treatment with erlotinib in a 63-year-old male NSCLC patient is presented. The present study highlights the importance of clinicians remaining cautious following erlotinib administration. In elderly NSCLC patients and those with a history of coronary heart disease, cardiac function must be carefully monitored following erlotinib treatment so that serious adverse reactions, such as myocardial infarction, may be identified early and treated quickly.

Highly Stretchable Conductive Fibers from Few-Walled Carbon Nanotubes Coated on Poly(m-phenylene isophthalamide) Polymer Core/Shell Structures

A core/shell stretchable conductive composite of a few-walled carbon nanotube network coated on a poly(m-phenylene isophthalamide) fiber (FWNT/PMIA) was fabricated by a dip-coating method and an annealing process that greatly enhanced interactions between the FWNT network and PMIA core as well as within the FWNT network. The first strain-conductivity test of the as-prepared FWNT/PMIA fiber showed a stretching-induced alignment of nanotubes in the shell during the deformation process and a good conductivity stability with a slight conductivity drop from 109.63 S/cm to 98.74 S/cm (Δσ/σ0 = 10%) at a strain of ∼150% (2.5 times the original length). More importantly, after the first stretching process, the fiber can be recovered with a slight increase in length but a greatly improved conductivity of 167.41 S/cm through an additional annealing treatment. The recovered fiber displays a similarly superb conductivity stability against stretching, with a decrease of only ∼13 S/cm to 154.49 S/cm (Δσ/σ0 = 8%) at a strain of ∼150%. We believe that this conductivity stability came from the formation and maintaining of aligned nanotube structures during the stretching process, which ensures the good tube-tube contacts and the elongation of the FWNT network without losing its conductivity. Such stable conductivity in stretchable fibers will be important for applications in stretchable electronics.

[mRNA-binding protein Human-antigen R regulates α-SMA expression in human bronchia smooth muscle cells]

OBJECTIVE

To investigate the role of mRNA binding protein Human-antigen R (HuR) in the over-expression of α-Smooth muscle actin (α-SMA) stimulated by Platelet-derived Growth Factor (PDGF) in cultured human bronchia smooth muscle cells.

METHODS

Human bronchia smooth muscle cells cultured in vitro were divided into 0, 6, 12 and 24 h groups according to the time of PDGF treatment. Total HuR protein and total α-SMA protein expression were detected by Western blot. Total HuR mRNA and total α-SMA mRNA level were determined by quantitative real time-polymerase chain reaction. RNA interference technology was used to down-regulate HuR protein level to study the protective effect of HuR in PDGF-stimulated α-SMA protein expression.

RESULTS

PDGF up-regulated the expression of HuR in a time-dependent manner. The relative expression levels of whole-cell HuR protein and mRNA in 0, 6, 12, 24 h groups were 0.23±0.09, 0.42±0.11, 0.93±0.21, 1.37±0.28; 1.00±0.00, 1.09±0.03, 1.16±0.03, 1.27±0.02 (all P<0.05). The relative expression levels of α-SMA protein and mRNA in 0, 6, 12, 24 h group also showed an increase trend marked in a time-dependent manner (1.03±0.08, 1.20±0.09, 1.39±0.11, 1.58±0.10; 1.00±0.00, 1.17±0.02, 1.23±0.02, 1.45±0.03; all P<0.05). Using RNA interference technology to down-regulate HuR protein level, there was a decrease in α-SMA protein expression.

CONCLUSION

PDGF stimulation can increase the expression of HuR and α-SMA in the smooth muscle cells, and HuR protein is involved in the expression of α-SMA protein stimulated by PDGF.

Human cytomegalovirus microRNA miR-US25-1-5p inhibits viral replication by targeting multiple cellular genes during infection

MicroRNAs (miRNAs) play important roles in regulating various cellular processes in plants, animals, and viruses. This mechanism is also utilized by human cytomegalovirus (HCMV) in the process of infection and pathogenesis. The HCMV-encoded miRNA, hcmv-miR-US25-1-5p, was highly expressed during lytic and latent infections, and was found to inhibit viral replication. Identification of functional target genes of this microRNA is important in that it will enable a better understanding of the function of hcmv-miR-US25-1-5p during HCMV infection. In the present study, 35 putative cellular transcript targets of hcmv-miR-US25-1-5p were identified. Down-regulation of the targets YWHAE, UBB, NPM1, and HSP90AA1 by hcmv-miR-US25-1-5p was validated by luciferase reporter assay and Western blot analysis. In addition, we showed that hcmv-miR-US25-1-5p could inhibit viral replication by interacting with these targets, the existence of which may impact virus replication directly or indirectly.

Effect of transforming growth factor-β1 869C/T polymorphism and radiation pneumonitis

BACKGROUND

The Transforming growth factor-β1 (TGFβ1) 869C/T polymorphism was associated with radiation pneumonitis (RP) susceptibility. However, the results remained controversial. Thus, a meta-analysis was conducted.

METHODS

Relevant studies were systematically searched by using the NCBI, Medline, Web of Science and Embase databases. Summary odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using random-effects models.

RESULTS

There was a significant association between TGFβ1 869C/T polymorphism and RP susceptibility (OR=1.77; 95% CI, 1.27-2.47; P=0.0007).

CONCLUSION

This study suggested that TGFβ1 869C/T polymorphism was a risk factor of RP.

[The value of transbronchial needle aspiration combined with rapid on-site evaluation of cytology in the diagnosis of lung cancer]

背景与目的

国内外目前已有多篇现场细胞学应用于经支气管镜针吸活检（transbronchial needle aspiration, TBNA）的报道，但专门针对肺癌患者的研究很少。本研究的目的是探讨TBNA联合现场细胞学在肺癌诊断中的作用。

方法

回顾性分析2012年12月-2013年12月在滨州市人民医院行TBNA并最终确诊为肺癌的69例患者，其中行现场细胞学者37例，未行现场细胞学者32例。比较现场细胞学结果与最终HE染色结果的一致性，同时比较两组患者的诊断率、每个淋巴结穿刺针数、并发症发生率及细胞学诊断费用。

结果

现场细胞学与HE染色一致性为94.1%（32/34）。现场细胞学组诊断率与非现场细胞学组相比无统计学差异（91.9% vs 78.1%, P=0.20）；但平均穿刺针数及并发症发生率，现场细胞学组少于非现场细胞学组（t=29.5, P < 0.05; χ²=4.4, P < 0.05），现场细胞学组患者细胞学诊断费用低于非现场细胞学组（t=10.9, P < 0.05）。

结论

TBNA联合现场细胞学诊断肺癌，与HE染色一致性好，且能减少穿刺针数及并发症，节省细胞学诊断费用，值得推广。

Tuning nondoped carbon nanotubes to an efficient metal-free electrocatalyst for oxygen reduction reaction by localizing the orbital of the nanotubes with topological defects

Breaking the electron delocalization of sp(2) carbon materials by heteroatom doping is a practical strategy to produce metal-free electrocatalysts of oxygen reduction reaction (ORR) for fuel cells. Whether carbon nanotubes (CNTs) can be efficiently tuned into ORR electrocatalysts only by intrinsic defects rather than heteroatom doping has not been well studied yet in experiment and theory. Here we introduce topological defects of nonhexagon carbon rings into CNTs to break the delocalization of their orbitals and make such type of CNTs to be a high-performance ORR catalyst. The electrochemical tests and theoretical studies indicate that the O₂ chemisorption and the following electrocatalytic activity are promoted by the introduced topological defects and show a strong dependence on the defect amount. Such topological-defect CNTs (TCNTs) have an excellent ORR performance owing to a 3.8-electron-transferring process, ∼4 times higher current density and ∼120 mV more positive peak potential than normally straight CNTs. Moreover, TCNTs show a higher steady-state diffusion current density and much better stability and immunity to crossover effect as compared with commercial Pt/C catalyst. Hence, our results strongly suggest that tuning the surface structure of CNTs with nonhexagon carbon rings is a novel strategy for designing advanced ORR electrocatalysts for fuel cells.

A microdeletion of chromosome 9q33.3 encompasses the entire LMX1B gene in a Chinese family with nail patella syndrome

Nail patella syndrome (NPS) is an autosomal dominant disorder characterized by nail malformations, patellar apoplasia, or patellar hypoplasia. Mutations within the LMX1B gene are found in 85% of families with NPS; thus, this gene has been characterized as the causative gene of NPS. In this study, we identified a heterozygous microdeletion of the entire LMX1B gene using multiplex ligation-dependent probe amplification (MLPA) in a Chinese family with NPS. The determination of the deletion breakpoints by Illumina genome-wide DNA analysis beadchip showed that the deletion was located in chromosome 9q33.3 and spanned about 0.66 Mb in size. This heterozygous deletion provides strong evidence for haploinsufficiency as the pathogenic mechanism of NPS.

[Primary pleural diffuse large B cell lymphoma:a case report and review of literature]

OBJECTIVE

To analyze the clinical features of 1 case of primary pleural diffuse large B-cell lymphoma (DLBCL) and therefore to improve the understanding of this disease.

METHODS

The clinical features, auxiliary examinations and diagnosis of a case with DLBCL were reported and the related literatures were reviewed. The literature review was carried out respectively with "primary pleural, lymphoma", as the search terms in Wanfang Data, CNKI and PubMed by December 2013.

RESULTS

A 73 year-old male patient was admitted to the hospital because of chest pain on the left side for 1 month. The main symptoms of the patient were left side chest pain, with occasional cough. Chest CT scan showed left pleural effusion and pleural thickening. Thoracoscopy was performed and revealed multiple sizes of nodules on the visceral and parietal pleura. Pathology study confirmed the diagnosis of DLBCL. The patient was treated with CHOP regimen 3 times. So far, there was no local recurrence. A total of 12 literatures were retrieved from Wanfang Data, CNKI and PubMed, and they were all case reports. There were 8 male and 4 female patients, aging from 12 to 81 years. The main symptoms were chest pain and fever.

CONCLUSIONS

Primary pleural DLBCL is a rare disease. It is easily to be misdiagnosed due to non-specific clinical and imaging manifestations. The final diagnosis depends ultimately on pathological biopsy, and thoracoscopy is the most effective method to confirm DLBCL.

A randomized controlled study of conventional TBNA versus EBUS-TBNA for diagnosis of suspected stage I and II sarcoidosis

OBJECTIVES

The aim of this study was to compare the diagnostic yield of TBNA and EBUS-TBNA in the patients with suspected stage I and II sarcoidosis in the case of the same number of needle aspiration lymph nodes and the same lymph nodes needle aspiration times.

METHODS

A total of 62 patients with suspected stage I and II sarcoidosis were randomly divided into TBNA group and EBUS-TBNA group, based on the clinical and radiologic manifestations. Biopsy specimens of each patient in both groups were taken from two lymph nodes with two needle passes per lymph node. The diagnostic yields of subgroup were separately calculated including the 4th and 7th lymph nodes (referred to as group A), in other stations (group B), greater than 15 mm and less than 15 mm in the shortest diameter.

RESULTS

The diagnostic yield of TBNA and EBUS-TBNA for sarcoidosis was 64% and 93%, respectively (χ2=7.12, P<0.05). Subgroup analysis showed that the percentages of positive pathological diagnosis in group A for TBNA and EBUS-TBNA were 79% and 95% (χ2=3.47, P>0.05). The percentages of positive pathological diagnosis greater than 15 mm in the shortest diameter were 78% and 94% (χ2=2.29, P>0.05).

CONCLUSION

The overall diagnostic yield of EBUS-TBNA for stage I and II sarcoidosis was higher than TBNA. However, Conventional TBNA has very high diagnostic yield similar to EBUS-TBNA, if the lymph nodes located on the 4th and 7th group or the shortest diameter was greater than 15 mm.

[Diagnostic value of interleukin-27 in tuberculous pleural effusion]

OBJECTIVE

To explore the diagnostic value of interleukin-27 (IL-27) in tuberculous pleural effusion.

METHODS

A total of 76 patients of pleural effusion treated at Shandong Provincial Hospital from March 2013 to February 2014 in accordance with the natures of effusion fluid were divided into: (1) Tuberculosis group of tuberculous pleural effusion (n = 40), including 22 males and 18 females; aged 19 to 73 years; (2) Malignant group of malignant pleural effusion (n = 36), including 20 males and 16 females; aged 33 to 78 years old; including lung cancer (n = 28), lymphoma (n = 3), esophageal (n = 1) and uncertain primary tumor site (n = 4). The effusion and serum levels of IL-27 were detected by enzyme-linked immunosorbent assay (ELISA) and the results analyzed. And the curve of receiver operating characteristic (ROC) was employed to determine the diagnostic value of IL-27 in tuberculous pleural effusion.

RESULTS

The level of IL-27 was (1 402 ± 321) ng/L in tuberculous pleural effusion and it was significantly higher than those in malignant pleural effusion (556 ± 133) ng/L and sera (499 ± 88) ng/L (both P < 0.05). According to the ROC curve, the cut-off value of IL-27 was 838 ng/L in diagnosing tuberculous pleural effusion. And the rates of diagnostic sensitivity, specificity and accuracy of IL-27 were 95.0%, 97.2% and 96.1% respectively.

CONCLUSIONS

Detection of pleural effusion IL-27 concentration is of great importance in the diagnosis of tuberculous pleural effusion. And it is worthy of wider clinical promotion.

[Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in conventional transbronchial needle aspiration negative paratracheal mediastinal lesions]

OBJECTIVE

To investigate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with mediastinal lesions and previously conventional TBNA-negative results.

METHODS

A total of 403 patients with mediastinal lesions on chest CT but negative results of routine bronchoscopy were enrolled at Shandong Provincial Hospital Affiliated to Shandong University from April 2009 to June 2013. Seventy-six cases with enlarged lesions surrounded with peripheral vascularity were allocated to group A and underwent EBUS-TBNA examination. The other 327 cases without peripheral vascularity were allocated to group B and underwent TBNA. Fifty-four of the 62 patients with previous TBNA (group B) negative results consequently underwent EBUS-TBNA were allocated to group C. The association between pathologic examinations and positive rate were analyzed.

RESULTS

Seventy-one cases in group A (93.4%) had a final diagnosis, of which 57 were diagnosed as malignant lesions and 14 as benign lesions. Two hundred and sixty-five cases in group B (81.0%) had a final diagnosis, of which 232 were malignant lesions and 33 benign lesions. Forty-nine cases (90.7%) in group C had a final diagnosis, of which 42 were malignant lesions and 7 benign lesions. The difference between group A and B was significant (χ(2) = 6.639, P = 0.010).

CONCLUSIONS

In conventional TBNA examination negative cases, a following EBUS-TBNA examination is necessary and has a satisfactory diagnostic efficacy.

Recipient-related clinical risk factors for primary graft dysfunction after lung transplantation: a systematic review and meta-analysis

Background

Primary graft dysfunction (PGD) is the main cause of early morbidity and mortality after lung transplantation. Previous studies have yielded conflicting results for PGD risk factors. Herein, we carried out a systematic review and meta-analysis of published literature to identify recipient-related clinical risk factors associated with PGD development.

Method

A systematic search of electronic databases (PubMed, Embase, Web of Science, Cochrane CENTRAL, and Scopus) for studies published from 1970 to 2013 was performed. Cohort, case-control, or cross-sectional studies that examined recipient-related risk factors of PGD were included. The odds ratios (ORs) or mean differences (MDs) were calculated using random-effects models

Result

Thirteen studies involving 10042 recipients met final inclusion criteria. From the pooled analyses, female gender (OR 1.38, 95% CI 1.09 to 1.75), African American (OR 1.82, 95%CI 1.36 to 2.45), idiopathic pulmonary fibrosis (IPF) (OR 1.78, 95% CI 1.49 to 2.13), sarcoidosis (OR 4.25, 95% CI 1.09 to 16.52), primary pulmonary hypertension (PPH) (OR 3.73, 95%CI 2.16 to 6.46), elevated BMI (BMI≥25 kg/m²) (OR 1.83, 95% CI 1.26 to 2.64), and use of cardiopulmonary bypass (CPB) (OR 2.29, 95%CI 1.43 to 3.65) were significantly associated with increased risk of PGD. Age, cystic fibrosis, secondary pulmonary hypertension (SPH), intra-operative inhaled nitric oxide (NO), or lung transplant type (single or bilateral) were not significantly associated with PGD development (all P>0.05). Moreover, a nearly 4 fold increased risk of short-term mortality was observed in patients with PGD (OR 3.95, 95% CI 2.80 to 5.57).

Conclusions

Our analysis identified several recipient related risk factors for development of PGD. The identification of higher-risk recipients and further research into the underlying mechanisms may lead to selective therapies aimed at reducing this reperfusion injury.

Primary pulmonary peripheral T-cell lymphoma: A case report and review of the literature

Primary pulmonary T-cell lymphoma is a rare condition characterized by fever, cough, dyspnea, and bilateral pulmonary nodules, usually diagnosed by transbronchial biopsy or computed tomography (CT) guided needle biopsy and pathology. In view of its poor prognosis, it is critical to distinguish and diagnose this disease as early as possible. We report here a case of a 39-year-old man who presented with fever, cough, expectoration with multiple nodules, and patch shadow in both lungs by chest CT. Tissue samples were taken by CT guided needle biopsy. The histological sample and immunohistochemistry showed peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS). After the patient was treated by chemotherapy for two courses, his condition deteriorated rapidly and he died 2.3 months after the onset of the disease.