[A case of intravascular lymphoma with diffuse centrilobular opacities].
A 54-year-old woman was admitted with general fatigue and dyspnea on exertion. Her serum LDH level was markedly elevated to 2145 IU/L, and chest CT revealed diffuse centrilobular opacities. Total cell counts in bronchoalveolar lavage fluid were elevated, and lymphocytes accounted for 98% of the cells. A transbronchial lung biopsy demonstrated numerous CD20-positive atypical cells in the alveolar capillaries, so intravascular lymphoma (IVL) was diagnosed as having. Lymphoma cells were also present in the bone marrow sinusoids, while there was no sign of hemophagocytosis. Combined chemotherapy (CHOP with rituximab) successfully induced complete remission, and she has been free of recurrence for 40 months. In cases with diffuse centrilobular opacities on chest CT, accompanied by elevated serum LDH, it is important to rule out IVL by performing TBLB.
Shinoda
Hiromi
H
Department of Respiratory Medicine, Tokyo Medical Center.
Maejima
Arafumi
A
Shimizu
Kumi
K
Onaka
Akio
A
Boku
Taigen
T
Oyamada
Yoshitaka
Y
D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011859:Radiography; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology