title: [Pulmonary intravascular large B-cell lymphomamanifesting as interstitial pneumonias: report of 2 cases and review of literature].
abstract: Objective:To investigate the clinical, radiographic characteristics and prognosis of pulmonary intravascular large B-cell lymphoma(IVLBCL) manifesting as interstitial pneumonias on HRCT.Methods:A retrospective analysis was carried out on clinical data of 2 patients with pulmonary IVLBCL admitted to the Affiliated Drum Tower Hospital of Nanjing University from March 2010 to May 2012. A literature research was performed with "pulmonary intravascular lymphoma" as the key word in Wanfang Database, China Knowledge Resource Integrated Database and Pubmed. The time interval was from January 1980 to June 2015. Related articles of pulmonary IVLBCL were retrieved and the clinical, radiographic characteristics and prognosis were analyzed.Results:The first patient was a 69 year-old female presenting with ground-glass opacities, interlobular septal thickening and patchy consolidation on HRCT, for whom the diagnosis was confirmed by transbronchial lung biopsy (TBLB). The second patient was a 70 year-old male presenting with diffuse ground-glass opacities on HRCT, and the diagnosis was made by pathology on video-assisted thoracoscopic biopsy. The 2 patients all presented with dyspnoea, cough, fever and elevated lactate dehydrogenase(LDH). The pathological study of lung biopsy specimen demonstrated invasion of atypical lymphocytes into small vessels and capillaries. The tumor cells were positive for CD(20).Literature review found 19 articles, all case reports with a total of 22 patients.Conclusions:The clinical manifestation of pulmonary IVLBCL was nonspecific and the disease progressed rapidly. For patients with interstitial pneumonias on HRCT, pulmonary IVLBCL needed to be considered as a differential diagnosis and pathological studies should be obtained as soon as possible, so that better prognosis could be archived through early intervention.
authors.affiliation: Department of Respiratory Medicine, the Affiliated Drum Tower Hospital of Nanjing University, Nanjing 210008, China.
authors.forename: T T
authors.initials: TT
authors.lastname: Zhao
authors.forename: M S
authors.initials: MS
authors.lastname: Cao
authors.forename: Y W
authors.initials: YW
authors.lastname: Zhang
authors.forename: J H
authors.initials: JH
authors.lastname: Dai
authors.forename: F Q
authors.initials: FQ
authors.lastname: Meng
authors.forename: H R
authors.initials: HR
authors.lastname: Cai
mesh_terms: D000368:Aged; D001402:B-Lymphocytes; D001706:Biopsy; D002681:China; D003371:Cough / Q000209:etiology; D018549:Cryptogenic Organizing Pneumonia; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000175:diagnosis* / Q000473:pathology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D007770:L-Lactate Dehydrogenase
keywords: Lung disease, interstitial; Lymphoma, B-cell; Pneumonia