Lymphomatoid granulomatosis in a 23-year-old man--cytological and histological typing and rapid response to steroid and cyclophosphamide combination therapy.
Lymphomatoid granulomatosis (LG) is currently called as extranodal angiocentric and angiodestructive immunoproliferative disorder with various degrees of histological differentiation and disease severity. Histological grading and clinical manifestations are due to number of atypical large EBV + B-lymphatic cells. We report the case of a 23-year-old man clinically presented with fever, sweating, and physical intolerance, and bilateral pulmonary infiltrates of nodular type and destructive changes on the chest X-ray, previously treated with antituberculotics for 1.5 month. As the disease showed progression, diagnostic procedures extended to transbronchial lung biopsy and percutaneous fine needle aspiration with cytological and histological analysis of collected specimens, all being not conclusive enough. LG was confirmed by open lung biopsy, followed by induction of corticosteroids and cyclophosphamide therapy. Very good clinical, functional and radiomorphologic improvement was achieved in a few weeks, and remission of disease maintained in long term follow-up.
Rakusić
Neven
N
University Hospital for Lung Diseases "Jordanovac", Zagreb, Croatia. neven.rakusic@zg.t-com.hr
Krmpotić
Diana
D
Hećimović
Ana
A
Boras
Zagorka
Z
Vrabec-Branica
Bozica
B
Dzebro
Sonja
S
Rakusić
Nevena
N
Resković
Tomislav
T
Rakusić
Nika
N
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D001402:B-Lymphocytes / Q000473:pathology / Q000821:virology; D044963:Biopsy, Fine-Needle; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D020031:Epstein-Barr Virus Infections / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D008230:Lymphomatoid Granulomatosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D011859:Radiography; D012074:Remission Induction; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide