[A case of B cell lymphoma with negative findings in both chest X-ray and CT images, but lesions of the bronchial mucosa detected on bronchoscopy].
A 68-year-old woman presented to our hospital on January 7, 1992 with swelling of a right cervical lymph node as the chief complaint. After biopsy of the cervical lymph node, non-Hodgkin's lymphoma was diagnosed (diffuse medium cell type, B cell) and she was hospitalized on January 10. Except for the enlargement of the right cervical lymph node noted at the time of hospitalization, no abnormal findings on examination or in chest X-ray and CT scan were noted. However, at bronchoscopy rubor and swelling of the mucosa of the right second carina and the bifurcation between the left upper division and the lingular bronchus were noted, and biopsy was therefore performed. The histologic appearance of the biopsy tissue was similar to that of the lymph node, showing infiltration by malignant lymphoma. The tumor was diagnosed to be stage IIA of the Ann Arbor classification, and COP-BLAM therapy was commenced on January 15. On January 21, the cervical lymph node was no langer present. At bronchoscopy performed on January 25, the abnormal portion of the bronchi had disappeared, and no infiltration was observed in the biopsied specimen. There have been some reports describing lesions within the bronchi in cases of malignant lymphoma. However, there have been few cases in which no abnormalities were found in the chest X-ray and diagnosis was made by bronchoscopy. Thus, it seems to be useful and important to perform bronchoscopy in order to determine the stage of malignant lymphoma.
Arai
N
N
First Department of Internal Medicine, Toho University School of Medicine, Ohmori Nishi, Tokyo, Japan.
Nakata
M
M
Shirai
T
T
D000368:Aged; D001980:Bronchi / Q000473:pathology*; D001984:Bronchial Neoplasms / Q000175:diagnosis*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis*; D009092:Mucous Membrane / Q000473:pathology; D009367:Neoplasm Staging; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed