Lymphomatoid Granulomatosis in a Patient with Chronic Lymphocytic Leukemia and Rapidly Progressing Peribronchovascular Pulmonary Infiltrates

Case Reports in Pulmonology
Shahab RezvaniAyad Al-Katib

Abstract

Lymphomatoid granulomatosis (LG) is an EBV-associated angiodestructive lymphoproliferative disease with multiorgan involvement that predominantly affects the lungs. We present a case of a 72-year-old man with a history of chronic lymphocytic leukemia who presented with upper respiratory symptoms and multiple erythematous skin papules. Chest CT showed ill-defined, irregular solid pulmonary nodules with peripheral ground-glass opacities in a peribronchovascular distribution. The differential for this pattern of lung disease is vast which includes but is not limited to infection, vasculitis, sarcoidosis, lymphoma, and Kaposi sarcoma. Subsequent PET/CT showed rapid progression of lung opacities and marked FDG uptake of pulmonary opacities and skin nodules, which raised the question of Richter syndrome. Wedge biopsy under video-assisted thoracoscopic surgery was performed. Pathology showed an extensive lymphoid infiltrate involving lymphatic and bronchovascular bundles and consisting of a mixture of large lymphocytes and inflammatory cells. Special stains showed that the large lymphocytes expressed B-cell markers and EBV virus. Overall, the findings were consistent with LG.

References

Nov 1, 1979·Clinical Radiology·P HickenE Frew
Dec 1, 1972·Human Pathology·A A LiebowP J Friedman
Oct 24, 2000·AJR. American Journal of Roentgenology·J S LeeD A Lynch
Oct 4, 2007·British Journal of Haematology·Kami Maddocks-ChristiansonTait D Shanafelt
Oct 16, 2013·The Journal of Experimental Medicine·Giulia FabbriRiccardo Dalla-Favera
Mar 29, 2014·Mediterranean Journal of Hematology and Infectious Diseases·Ruben Fernandez-AlvarezCarmen Fernandez
Jan 14, 2016·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Arlene SirajuddinCharles S White

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BETA
biopsy
biopsies

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