title: [A case of Epstein-Barr virus-positive diffuse large B-cell lymphoma in an elderly person with a necrotizing pulmonary bulky mass].
abstract: A 52-year-old man presented with a pulmonary bulky mass, fever and cough. Chest CT showed a necrotizing bulky mass 10 cm in diameter in the right lung lower lobe. Transbronchial biopsy and CT-guided biopsy of the tumor and endobronchial ultrasound-guided transbronchial needle aspiration of the right hilar lymph node did not yield a definitive diagnosis, but the histological findings showed necrosis. We performed CT-guided biopsy of the part of the lesion where a high uptake of FDG-PET was observed. The histological diagnosis was diffuse large B-cell lymphoma. The immunohistochemical findings were positive for Epstein-Barr virus (EBV). Because the patient was more than 50 years old and had no underlying diseases, he was given a diagnosis of EBV-positive diffuse large B-cell lymphoma of an elderly patient. The pulmonary manifestation of this disease as a bulky tumor is extremely rare. In spite of the presence of a bulky pulmonary tumor, the EBV-positive diffuse large B-cell lymphoma contained necrotizing tissue, and it was difficult to obtain tissue specimens for histological examination.
authors.affiliation: Departmentof Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University.
authors.forename: Shinya
authors.initials: S
authors.lastname: Sakata
authors.forename: Junji
authors.initials: J
authors.lastname: Hamamoto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Sugahara
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ichiyasu
authors.forename: Naoki
authors.initials: N
authors.lastname: Saita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Iyama
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kohrogi
mesh_terms: D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D008168:Lung / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis