Primary tracheal lymphoma causing respiratory failure.
Lymphomatous involvement of the airway causing stridor is a rare but frightening presentation of an eminently treatable condition. We describe a 24-year-old woman with tracheal non-Hodgkin lymphoma who was initially diagnosed with asthma, but subsequently presented with near-fatal acute upper airway obstruction because of a tracheal Anaplastic Lymphoma Kinase (ALK)+ anaplastic T-cell lymphoma. The obstructing tumor was extricated by means of rigid bronchoscopy. After six cycles of Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone chemotherapy, the patient went into complete clinical remission. A high index of suspicion in patients with dyspnoea and wheeze unresponsive to bronchodilators is crucial in early diagnosis of tracheal tumors.
Tan
Daniel S W
DS
Department of Medical Oncology, National Cancer Centre Singapore, Singapore. daniel.tan.s.w@nccs.com.sg
Eng
Philip C T
PC
Lim
Soon Thye
ST
Thye
Lim Soon
LS
Tao
Miriam
M
D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy; D011241:Prednisone / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000378:metabolism; D020794:Receptor Protein-Tyrosine Kinases; D012074:Remission Induction; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed; D014134:Tracheal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy; D014750:Vincristine / Q000627:therapeutic use
D014408:Biomarkers, Tumor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases; D011241:Prednisone