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Sudden resolution of pulmonary lesions after systemic chemotherapy for high grade Non-Hodgkin lymhpoma

Year 2009, Volume: 36 Issue: 4, 301 - 305, 01.12.2009

Abstract

Pulmonary infiltrations of lymphomas presents as primary or secondary forms. The lymphoma cells infiltrate widely in the lung A 57-year old man admitted to our hospital with chest pain, nodal enlargement in neck, malaise, cough, and sputum. The patient was hospitalized due to the signs of hepato-splenomegaly, weight lost, fever, and growing mass in left neck. Physical examination revealed painful lymph node. In chest examination, there was low amplitude of pulmonary sounds in right basal area and occasional crepitan ralles. Hepatomegaly and splenomegaly were detected. The patient had parahilar non-homogenous diffuse infiltration in chest X-ray. The patient also had abnormal chest tomographic findings. The patient had diagnosis of high grade large cell non-Hodgkin lymphoma proven by histologically. The patient has been treated with 6 courses CEOP chemotherapy. The patient was in good condition without evidence of previously existing pulmonary lesions after completion of chemotherapy. This patient had sudden resolution of pulmonary lesions with long lasting remission after systemic chemotherapy for high grade large cell Non-Hodgkin lymhpoma involving the lung. Keywords: Lung, pulmonary lesions, lymphoma, Chemotherapy

References

  • Newton R, Ferlay J, Beral V, Devesa SS. The epidemiology of non-Hodgkin's lymphoma: comparison of nodal and ex- tra-nodal sites. Int J Cancer 1997;72:923-930.
  • Cordier JF, Chailleux E, Lauque D, et al. Primary pulmo- nary lymphomas. A clinical study of 70 cases in nonim- munocompromised patients. Chest 1993;103:201-208.
  • L'Hoste RJ, Filippa DA, Lieberman PH, Bretsky S. Primary pulmonary lymphomas. A clinicopathologic analysis of 36 cases. Cancer 1984;54:399-406.
  • Fiche M, Caprons F, Berger F, Galateau F, Cordier JF, Loire R, et al. Primary pulmonary non-Hodgkin's lymphomas. Histopathology 1995;26:529-37.
  • Li G, Hansmann ML, Zwingers T, Lennert K. Primary lym- phomas of the lung: morphological, immunohistochemical and clinical features. Histopathology 1990;16:519-531.
  • Nicholson AG, Wotherspoon AC, Diss TC, et al. Pulmo- nary B-cell non-Hodgkin's lymphomas. The value of im- munohistochemistry and gene analysis in diagnosis. His- topathology 1995;26:395-403.
  • Addis BJ, Hyjek E, Isaacson PG. Primary pulmonary lym- phoma: a re-appraisal of its histogenesis and its relation- ship to pseudolymphoma and lymphoid interstitial pneu- monia. Histopathology 1988;13:1-17.
  • Herbert A, Wright DH, Isaacson PG, Smith JL. Primary ma- lignant lymphoma of the lung: histopathologic and immu- nologic evaluation of nine cases. Hum Pathol 1984;15:415-22.
  • Le Tourneau A, Audouin J, Garbe L, et al. Primary pulmo- nary malignant lymphoma, clinical and pathological find- ings, immunocytochemical and ultrastructural studies in 15 cases. Hematol Oncol 1983;1:49-60.
  • Peterson H, Snider HL, Yam LT, Bowlds CF, Arnn EH, Li CY. Primary pulmonary lymphoma. A clinical and immu- nohistochemical study of six cases. Cancer 1985;56:805- 813.
  • Subramanian D, Albrecht S, Gonzalez JM, Cagle PT. Pri- mary pulmonary lymphoma. Diagnosis by immunoglobu- lin gene rearrangement study using a novel polymerase chain reaction technique. Am Rev Respir Dis 1993;148:222-226.
  • Philippe B, Delfau-Larue MH, Epardeau B, et al. B-cell pulmonary lymphoma: gene rearrangement analysis of bronchoalveolar lymphocytes by polymerase chain reac- tion. Chest 1999;115:1242-1247.
  • Harris NL, Jaffe ES, Stein H, et al. A revised European- American classification of lymphoid neoplasms: a pro- posal from the International Lymphoma Study Group. Blood 1994;84:1361-1392.
  • Harris NL, Jaffe ES, Diebold J, et al.. Lymphoma classifi- cation--from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol 2000;11 Suppl 1:3-10.
  • Cadranel J, Naccache J, Wislez M, Mayaud C. Pulmonary malignancies in the immunocompromised patient. Respi- ration 1999;66:289-309.
  • Ray P, Antoine M, Mary-Krause M, et al. AIDS-related primary pulmonary lymphoma. Am J Respir Crit Care Med 1998;158:1221-9.
  • Strimlan CV, Taswell HF, Kueppers F, DeRemee RA, McDonald TJ. HLA-A antigens of patients with Wegener's
  • granulomatosis. Tissue Antigens 1978;11:129-131.
  • Costabel U, Bross KJ, Matthys H. Diagnosis by bron- choalveolar lavage of cause of pulmonary infiltrates in haematological malignancies. Br Med J (Clin Res Ed) 1985;290:1041-1043.
  • Schwaiger A, Prior C, Weyrer K, et al. Non-Hodgkin's lymphoma of the lung diagnosed by gene rearrangement from bronchoalveolar lavage fluid: a fast and noninvasive method. Blood 1991;77:2538-2539.
  • Pisani RJ, Witzig TE, Li CY, Morris MA, Thibodeau SN. Confirmation of lymphomatous pulmonary involvement by immunophenotypic and gene rearrangement analysis of bronchoalveolar lavage fluid. Mayo Clin Proc 1990;65:651-656.
  • Wislez M, Cadranel J, Antoine M, et al. Lymphoma of pulmonary mucosa-associated lymphoid tissue: CT scan findings and pathological correlations. Eur Respir J 1999;14:423-429.

Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi

Year 2009, Volume: 36 Issue: 4, 301 - 305, 01.12.2009

Abstract

Lenfomalarda akciğer tutulumu primer ve sekonder olmak üzere iki şekilde görülmektedir. Lenfoma hücreleri, akciğerin değişik bölgelerini, yoğun biçimde infiltre edebilmektedir. 57 yaşında erkek hastanın 6 aydır devam eden göğüs ağrısı, boyunda şişlik, halsizlik, öksürük ve balgam yakınmaları mevcuttu. Hasta, hepatosplenomegali, son bir ayda kilo kaybı, ateş ve boynunun sol yanında büyüyen ağrılı şişlik nedeniyle kliniğimize yatırıldı. Fizik muayenede, boyunda ağrılı lenfadenopati saptandı. Solunum sistemi muayenesinde sağda solunum seslerinin şiddetinde azalma, yer yer krepitan raller mevcuttu. PA akciğer grafisinde sağ parahiler bölgede non homojen yaygın infiltrasyon saptandı. Toraks tomografisinde ise sağ akciğerde santralde hava bronkogramı izlenen konsolide alan, periferde nodüler ve retikülonodüler, sol akciğer alt lop posterobazal segmentte ve sol akciğer üst lop apikoposterior segmentte birkaç adet nodüler lezyon, paratrakeal lenf bezi ve lokalize alveoler diffüz infiltrasyonlar saptandı. Servikal lenf nodunu histolojik incelenmesinde yüksek grade büyük hücreli Non-Hodgkin lenfoma tanısı kondu. Hasta 6 siklus CEOP kürü aldı. Kemoterapi tamamlandıktan sonra yapılan incelemelerde daha önce varolan akciğer lezyonlarının tümünün kaybolduğu görüldü. Bu vaka sistemik non-Hodgkin lenfoma seyri sırasında akciğeri tutulumu gelişen ve tek başına kemoterapi ile uzun süreli remisyona giren bir nadir olgudur.

References

  • Newton R, Ferlay J, Beral V, Devesa SS. The epidemiology of non-Hodgkin's lymphoma: comparison of nodal and ex- tra-nodal sites. Int J Cancer 1997;72:923-930.
  • Cordier JF, Chailleux E, Lauque D, et al. Primary pulmo- nary lymphomas. A clinical study of 70 cases in nonim- munocompromised patients. Chest 1993;103:201-208.
  • L'Hoste RJ, Filippa DA, Lieberman PH, Bretsky S. Primary pulmonary lymphomas. A clinicopathologic analysis of 36 cases. Cancer 1984;54:399-406.
  • Fiche M, Caprons F, Berger F, Galateau F, Cordier JF, Loire R, et al. Primary pulmonary non-Hodgkin's lymphomas. Histopathology 1995;26:529-37.
  • Li G, Hansmann ML, Zwingers T, Lennert K. Primary lym- phomas of the lung: morphological, immunohistochemical and clinical features. Histopathology 1990;16:519-531.
  • Nicholson AG, Wotherspoon AC, Diss TC, et al. Pulmo- nary B-cell non-Hodgkin's lymphomas. The value of im- munohistochemistry and gene analysis in diagnosis. His- topathology 1995;26:395-403.
  • Addis BJ, Hyjek E, Isaacson PG. Primary pulmonary lym- phoma: a re-appraisal of its histogenesis and its relation- ship to pseudolymphoma and lymphoid interstitial pneu- monia. Histopathology 1988;13:1-17.
  • Herbert A, Wright DH, Isaacson PG, Smith JL. Primary ma- lignant lymphoma of the lung: histopathologic and immu- nologic evaluation of nine cases. Hum Pathol 1984;15:415-22.
  • Le Tourneau A, Audouin J, Garbe L, et al. Primary pulmo- nary malignant lymphoma, clinical and pathological find- ings, immunocytochemical and ultrastructural studies in 15 cases. Hematol Oncol 1983;1:49-60.
  • Peterson H, Snider HL, Yam LT, Bowlds CF, Arnn EH, Li CY. Primary pulmonary lymphoma. A clinical and immu- nohistochemical study of six cases. Cancer 1985;56:805- 813.
  • Subramanian D, Albrecht S, Gonzalez JM, Cagle PT. Pri- mary pulmonary lymphoma. Diagnosis by immunoglobu- lin gene rearrangement study using a novel polymerase chain reaction technique. Am Rev Respir Dis 1993;148:222-226.
  • Philippe B, Delfau-Larue MH, Epardeau B, et al. B-cell pulmonary lymphoma: gene rearrangement analysis of bronchoalveolar lymphocytes by polymerase chain reac- tion. Chest 1999;115:1242-1247.
  • Harris NL, Jaffe ES, Stein H, et al. A revised European- American classification of lymphoid neoplasms: a pro- posal from the International Lymphoma Study Group. Blood 1994;84:1361-1392.
  • Harris NL, Jaffe ES, Diebold J, et al.. Lymphoma classifi- cation--from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol 2000;11 Suppl 1:3-10.
  • Cadranel J, Naccache J, Wislez M, Mayaud C. Pulmonary malignancies in the immunocompromised patient. Respi- ration 1999;66:289-309.
  • Ray P, Antoine M, Mary-Krause M, et al. AIDS-related primary pulmonary lymphoma. Am J Respir Crit Care Med 1998;158:1221-9.
  • Strimlan CV, Taswell HF, Kueppers F, DeRemee RA, McDonald TJ. HLA-A antigens of patients with Wegener's
  • granulomatosis. Tissue Antigens 1978;11:129-131.
  • Costabel U, Bross KJ, Matthys H. Diagnosis by bron- choalveolar lavage of cause of pulmonary infiltrates in haematological malignancies. Br Med J (Clin Res Ed) 1985;290:1041-1043.
  • Schwaiger A, Prior C, Weyrer K, et al. Non-Hodgkin's lymphoma of the lung diagnosed by gene rearrangement from bronchoalveolar lavage fluid: a fast and noninvasive method. Blood 1991;77:2538-2539.
  • Pisani RJ, Witzig TE, Li CY, Morris MA, Thibodeau SN. Confirmation of lymphomatous pulmonary involvement by immunophenotypic and gene rearrangement analysis of bronchoalveolar lavage fluid. Mayo Clin Proc 1990;65:651-656.
  • Wislez M, Cadranel J, Antoine M, et al. Lymphoma of pulmonary mucosa-associated lymphoid tissue: CT scan findings and pathological correlations. Eur Respir J 1999;14:423-429.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Case Reports
Authors

Kendal Yalçın This is me

Orhan Ayyıldız This is me

Publication Date December 1, 2009
Submission Date March 2, 2015
Published in Issue Year 2009 Volume: 36 Issue: 4

Cite

APA Yalçın, K., & Ayyıldız, O. (2009). Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi. Dicle Tıp Dergisi, 36(4), 301-305.
AMA Yalçın K, Ayyıldız O. Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi. diclemedj. December 2009;36(4):301-305.
Chicago Yalçın, Kendal, and Orhan Ayyıldız. “Yüksek Dereceli Non-Hodgkin Lenfomalı Hastada Sistemik Kemoterapi Sonrası akciğer lezyonlarının Ani düzelmesi”. Dicle Tıp Dergisi 36, no. 4 (December 2009): 301-5.
EndNote Yalçın K, Ayyıldız O (December 1, 2009) Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi. Dicle Tıp Dergisi 36 4 301–305.
IEEE K. Yalçın and O. Ayyıldız, “Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi”, diclemedj, vol. 36, no. 4, pp. 301–305, 2009.
ISNAD Yalçın, Kendal - Ayyıldız, Orhan. “Yüksek Dereceli Non-Hodgkin Lenfomalı Hastada Sistemik Kemoterapi Sonrası akciğer lezyonlarının Ani düzelmesi”. Dicle Tıp Dergisi 36/4 (December 2009), 301-305.
JAMA Yalçın K, Ayyıldız O. Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi. diclemedj. 2009;36:301–305.
MLA Yalçın, Kendal and Orhan Ayyıldız. “Yüksek Dereceli Non-Hodgkin Lenfomalı Hastada Sistemik Kemoterapi Sonrası akciğer lezyonlarının Ani düzelmesi”. Dicle Tıp Dergisi, vol. 36, no. 4, 2009, pp. 301-5.
Vancouver Yalçın K, Ayyıldız O. Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi. diclemedj. 2009;36(4):301-5.