Pnömokonyoza Eşlik Eden Lenfoma Olgusu

Öz

Non-Hodgkin Lenfoma (NHL), en sık görülen hematolojik malignite olup Diffüz Büyük B Hücreli Lenfoma (DBBHL) en sık görülen histolojik tipidir. 56 yaşında erkek hasta kliniğimize 1 aydır devam eden nefes darlığı ve halsizlik şikayetleri ile başvurdu. Meslek öyküsünde 30 yıldır diş teknisyenliği yaptığı öğrenildi. 2020 yılında pnömokonyoz tanısı mevcuttu ve pnömokonyoz radyografilerinin International Labour Organization (ILO) Uluslararası Sınıflandırması’na göre akciğer radyografisi q/t 3/3 idi. Laboratuar incelemelerinde eritrosit sedimantasyon hızında (ESR 50 mm/h) ve serum laktat dehidrojenaz (LDH 368 IU/L) düzeylerinde yükselme saptandı. Çekilen torakal bilgisayarlı tomografide (BT)’de mediastinal, subkarinal ve bilateral hiler alanlarda yer yer konglomerasyon gösteren ve yer yer kalsifikasyonlar içeren büyümüş lenf nodları ve lenfadenopatiler (LAP) görüldü. Sağ orta zonda daha belirgin olmak üzere her iki akciğerde hilustan parankime uzanan, internal kalsifikasyonlar içeren, geniş yayılımlı inhomojen kitlesel vasıfta konsolidasyon alanları izlendi. Her iki akciğerde yaygın interstisyel kalınlaşmalar, infiltrasyonlar ve sentrilobüler nodüler dansite artışları, özellikle sol üst zonda daha belirgin olmak üzere çekintili konturlu nodüler konsolide alanlar ve nodüller ile buzlu cam dansiteleri izlendi. Sol 5. kot lateral kesiminde yaklaşık 12x5 cm boyutunda, kortikal destrüksiyona neden olan, çevre yumuşak dokular ve kas planlarını invaze eden, internal kistik-nekrotik komponentler içeren heterojen yumuşak doku kitlesi izlendi. Abdomen BT’de abdomende bir kısmı kalsifikasyonlar içeren büyümüş lenf nodları ve LAP’lar izlendi. PMF için tipik olmayan radyografik görünümler nedeniyle transtorasik biyopsi yapılan hastada patoloji sonucu Diffüz B Hücreli Lenfoma olarak raporlandı. Burada mesleki karsinojen maruziyeti olan ve lenfoma ile prezente olan pnömokonyoz tanılı olguyu sunduk.

Anahtar Kelimeler

• pnömokonyoz
• lenfoma
• meslek

Lymphoma Accompanyıng Pneumoconıosıs; Case Report

Öz

Non-Hodgkin Lymphoma (NHL) is the most common hematological malignancy, and Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological type. A 56-year-old male patient was admitted to our clinic with complaints of shortness of breath and fatigue for 1 month. It was learned in his professional history that he had been a dental technician for 30 years. He was diagnosed with pneumoconiosis in 2020 and his chest radiograph was q/t 3/3 according to the International Labor Organization (ILO) International Classification of pneumoconiosis radiographs. Laboratory examinations revealed an increase in erythrocyte sedimentation rate (ESR 50 mm/h) and serum lactate dehydrogenase (LDH 368 IU/L) levels. On thoracic computed tomography (CT), enlarged lymph nodes and lymphadenopathies (LAP) with local conglomeration and calcifications in the mediastinal, subcarinal and bilateral hilar areas were seen. Widely disseminated inhomogeneous mass-like consolidation areas, including internal calcifications, extending from the hilum to the parenchyma in both lungs, were observed more prominently in the right middle zone. Diffuse interstitial thickenings, infiltrations and centrilobular nodular density increases in both lungs, nodular consolidated areas with recessed contours and nodules and ground glass densities were observed, especially in the left upper zone. In the lateral part of the left 5th rib, a heterogeneous soft tissue mass of approximately 12x5 cm, causing cortical destruction, invading the surrounding soft tissues and muscle planes, and containing internal cystic-necrotic components was observed. On abdominal CT, enlarged lymph nodes and LAPs, some of which contain calcifications, were observed in the abdomen. The pathology result was reported as Diffuse B-Cell Lymphoma in the patient who underwent transthoracic biopsy due to radiographic appearances that are not typical for PMF. Here, we presented a case of pneumoconiosis with occupational carcinogen exposure and presenting with lymphoma.

Anahtar Kelimeler

• pneumoconiosis
• lymphoma
• occupation

Kaynakça

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