Primary pulmonary intravascular large B‑cell lymphoma misdiagnosed as pneumonia: Four case reports and a literature review

Primary pulmonary intravascular large B-cell lymphoma (IVLBCL) is a rare, malignant extranodal lymphoma. It is difficult to diagnose clinically as it requires a combination of clinical and computed tomography (CT) evaluations, as well as laboratory and pathological examinations. In the present study...

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Bibliographic Details
Published in:Oncology letters 2023-06, Vol.25 (6), p.1, Article 234
Main Authors: Zhu, Mengxia, Chang, Ying, Fan, Haijian, Shi, Jiong, Zhu, Bin, Mai, Xiaoli
Format: Article
Language:English
Subjects:
B cells
Bacterial pneumonia
Biopsy
Blood
Bone marrow
C-reactive protein
Cancer
Case Report
Case reports
Chemotherapy
CT imaging
Cyanosis
Drug dosages
Dyspnea
Fever
Hospitals
Hypoxemia
Infections
Laboratories
Lung diseases
Lungs
Lymphoma
Medical examination
Nervous system
Non-Hodgkin's lymphomas
Patients
Pneumonia
Skin
Sodium
Tomography
Tumors
Vincristine
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Summary:Primary pulmonary intravascular large B-cell lymphoma (IVLBCL) is a rare, malignant extranodal lymphoma. It is difficult to diagnose clinically as it requires a combination of clinical and computed tomography (CT) evaluations, as well as laboratory and pathological examinations. In the present study, 4 cases of primary pulmonary IVLBCL were reviewed. The patients' ages ranged from 60 to 69 years old. Of the 4 patients, 3 developed progressive dyspnea on exertion and intermittent fever. Other symptoms included coughing, chest tightness and weight loss. Laboratory data indicated that all patients had anemia, thrombocytopenia, hypoxemia, a markedly high serum lactate dehydrogenase level, elevated erythrocyte sedimentation rate and increased C-reactive protein. CT demonstrated increased attenuation in bilateral lung parenchyma, especially in the upper lobes, with multiple ground-glass opacities associated with small nodules in these patients. Initially, all 4 patients were misdiagnosed with pneumonia. However, none of them responded to anti-inflammatory treatments. The pathologies of all patients were confirmed using lung biopsy. Only 1 patient received regular combination chemotherapy. Based on the observations of the present study, a standard regimen for lymphoma treatment may result in a notable clinical response.
ISSN:1792-1074
1792-1082
DOI:10.3892/ol.2023.13820