Migratory nodules in the lung: lymphomatoid granulomatosis.
A 45-year-old woman was admitted with complaints of non-productive cough, chest pain, fatigue and weight loss in the last 4 months. On physical examination moderate hepatosplenomegaly and crackles most notably on the basal region of the right lung were evident. Serial chest X-rays and computed tomographies revealed a migratory nodular infiltration pattern, changing in location and size in both the lungs. The histopathological diagnosis of the open lung biopsy was lymphomatoid granulomatosis (LG) with a marked angioinvasive lymphocytic perivascular and peribronchial infiltration pattern. In the immunohistochemical analyses LCA, CD-79, CD-20 were positive, while CD-30 was negative. No response could have been achieved under combination chemotherapy and the patient died from progressive disease. LG is a rare disease and a difficult diagnosis in the routine clinical practice. This report emphasises that, LG should be considered especially when there are migratory nodules of varying sizes in lungs.
Bolaman
Zahit
Z
Division of Haematology, Department of Internal Medicine, Adnan Menderes University Medical School, Aydin, Turkey. zahitb@yahoo.com
Kadiköylü
Gürhan
G
Polatli
Mehmet
M
Barutca
Sabri
S
Culhaci
Nil
N
Sentürk
Taşkin
T
D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008175:Lung Neoplasms / Q000473:pathology*; D008230:Lymphomatoid Granulomatosis / Q000175:diagnosis*; D018447:Medical Futility; D009361:Neoplasm Invasiveness / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography