title: Ground-glass opacities and a solitary nodule on chest in intravascular large B-cell lymphoma.
abstract: A 74-year-old woman presented with dyspnea on exertion and nocturnal cough. Chest computed tomography (CT) revealed scattered bilateral ground-glass opacities without a zonal dominance. Bronchoalveolar lavage elicited increased lymphocytes, but transbronchial lung biopsies were not performed because of hypoxemia during the examination. She received steroid therapy because of her subsequent worsening respiratory condition, but her condition continued to deteriorate. The ground-glass opacities partially consolidated with the appearance of new ground-glass opacities and a nodular shadow. Hepatosplenomegaly was observed on CT while soluble interleukin-2 receptor was elevated. A biopsy of a Campbell de Morgan spot of the trunk yielded a diagnosis of intravascular large B-cell lymphoma. There was marked clearing of the pulmonary infiltrates and significant symptomatic improvement in response to systemic chemotherapy.
authors.affiliation: Second Department of Internal Medicine, Nara Medical University Kashihara, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Katayama
authors.affiliation: Second Department of Internal Medicine, Nara Medical University Kashihara, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomoda
authors.affiliation: Second Department of Internal Medicine, Nara Medical University Kashihara, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohya
authors.affiliation: Department of Dermatology, Nara Medical University Kashihara, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Asada
authors.affiliation: Department of Diagnostic Pathology, Nara Medical University Kashihara, Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Ohbayashi
authors.affiliation: Second Department of Internal Medicine, Nara Medical University Kashihara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
keywords: Campbell de Morgan spot; chest CT imaging; heterogeneous ground-glass opacities; intravascular large B-cell lymphoma (IVLBCL); solitary nodule