Publication
Title
Pulmonary mass: never judge a book by its cover
Author
Abstract
This case shows that a tumor can present in an uncommon way. When dealing with pulmonary masses, tissue remains the most important issue. We present the case of a 71-year-old woman with a mass of more than 10 cm in the left lung. Pulmonary CT scan and PET scan confirmed this with also revealing mediastinal, thoracic and paravertebral invasion, without extrathoracic metastatic lesions. Bronchoscopic evaluation and ultrasound guided transbronchial needle aspiration could not yield a diagnosis. Because of rapid clinical deterioration, new imaging was performed, showing a cavitary lesion with air-fluid level in the tumor. Extensive microbiological work-up remained negative. To yield a pathological diagnosis, we performed a thoracotomy, revealing a polymorphic lymphoid infiltrate with scattered large atypical B-cells infected with Epstein-Barr virus, vasculitis and granulomatosis leading to a diagnosis of Lymphomatoid Granulomatosis. The patient received 6 cycles of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Methylprednisolone), 2 doses of Rituximab monotherapy, 4 doses of intrathecal Methotrexate and consolidation radiotherapy with a complete response. Lymphomatoid granulomatosis (LYG) is a rare pulmonary disease, which should be included in the differential diagnosis of 'a pulmonary mass'. This case emphasizes the need for tissue acquisition.
Language
English
Source (journal)
memo - Magazine of European Medical Oncology
Publication
2018
ISSN
1865-5041
Volume/pages
11 :2 (2018) , p. 158-160
ISI
000435629800018
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 10.07.2018
Last edited 24.08.2021
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