Primary Pulmonary T-Cell Lymphoma in a Human T-Lymphotropic Virus Type-1 Carrier Showing Atypical Shadow

Primary pulmonary T-cell lymphoma mimicking pneumonia: A case report and literature review

Primary pulmonary T-cell lymphoma is an extremely rare neoplasm. The present study describes the case of an elderly male patient who was admitted to hospital with initial symptoms including a fever, coughing and dyspnea. A chest computed tomography scan detected pneumonia-like features, including multiple variable nodules, ground-glass opacities, patchy infiltration and subpleural consolidation, which progressed rapidly. No mediastinal or hilar adenopathy was noted. The patient was initially diagnosed with severe pneumonia; however, the patient developed severe respiratory failure and extensive progression in radiographic manifestation despite receiving a combination treatment of broad-spectrum antibiotics and antifungal agents. Negative results were obtained for anti-nuclear antibodies and anti-neutrophil cytoplasmic antibody assays, which eliminated the possibility that the patient was affected by a connective tissue disease. A bronchoscopy with transbronchial lung biopsy was not performed on account of intolerance. A histological examination, which was performed using specimens obtained via video-assisted thoracoscopic surgery, allowed the final diagnosis of T-cell lymphoma to be confirmed. Unfortunately, the patient succumbed to respiratory failure and a probable thoracic hemorrhage prior to the initiation of chemotherapy.

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.

Lymphoproliferative neoplasms of the lung: a review

CONTEXT

Diagnosis and classification of lymphomas are based on the morphologic, immunologic, and genetic features that the lesional cells share with their normal B and T lymphocyte counterparts. Primary pulmonary lymphomas account for 0.3% of primary lung neoplasms and less than 0.5% of all lymphomas.

OBJECTIVE

To describe and summarize the clinical and histopathologic features of the primary pulmonary lymphoma and secondary involvement of the lung by lymphoma.

DATA SOURCES

Peer-reviewed published literature and personal experience.

CONCLUSIONS

Diagnosis of clonal lymphoid proliferations in the lung has evolved owing to the greater utility of molecular and flow cytometric analysis of tissue. Further studies are needed to best define the clinical and prognostic features, as well as search for targeted therapy for these patients with rare neoplasms.