Primary lung lymphoma is a rare entity accounting for approximately 0.3% of all primary neoplasia of the lung and includes diffuse large B-cell lymphoma (DLBL) and lymphomatoid granulomatosis (LYG). Considering that clinical features may be similar, whereas epidemiology, morphology, and radiological features are different, the authors report a case of a middle-aged man who presented multiple pulmonary nodules in the lower lobes and ground-glass opacities scattered bilaterally on computed tomography. Clinically, he presented a consumptive syndrome with respiratory failure and pleurisy, which progressed until death. The autopsy findings were consistent with lymphomatoid granulomatosis (LYG) grade 3/ diffuse large B-cell lymphoma (DLBL). The authors call attention to the difficulty of establishing an accurate diagnosis, mainly when the demonstration of EBV-infected atypical B-cells fails.
BooneJM, ZhangD, FanF. Lymphomatoid Granulomatosis: a case report with unique clinical and histopathologic features. Ann Clin Lab Sci. 2013;43:181-5.
Rooper L, Gocke CD, Belchis DA. Pleural fluid cytology of the polymorphous variant of EBV-positive diffuse large B-cell lymphoma: first report and distinction from a reactive process. Case Rep Pathol. 2013. Epub 2013 Sep 3. http://dx.doi.org/ [https://doi.org/10.1155/2013/450279]10.1155/2013/450279
Pitaluga S, Wilson WH, Jaffe ES. Lymphomatoid granulomatosis. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO Classification of Tumors of Haematopoietic and Lymphoid Tisssues. Lyon: ARC; 2008. p. 247-9.
WilsonWH, KingmaDW, RaffeldM, WittesRE, JaffeES. Association of lymphomatoid granulomatosis with Epstein-Barr viral infection of B lymphocytes and response to interferon-alpha 2b. Blood. 1996;87:4531-7.
AokiT, HaradaY, MatsubaraE. Long-term remission after multiple relapses in an elderly patient with lymphomatoid granulomatosis after rituximab and high-dose cytarabine chemotherapy without stem-cell transplantation. J Clin Oncol. 2013;31:e390-3. http://dx.doi.org/ [https://doi.org/10.1200/JCO.2012.47.4999].