Korean J Radiol.  2010 Apr;11(2):234-238. 10.3348/kjr.2010.11.2.234.

Primary Pulmonary T-Cell Lymphoma: a Case Report

• Shin CH
• Paik SH
• Park JS
• Kim HK
• Park SI
• Cha JG
• Koh ES

• KMID: 1783201
• DOI: http://doi.org/10.3348/kjr.2010.11.2.234

Abstract

Primary pulmonary T-cell lymphoma is an extremely rare malady, and we diagnosed this in a 52-year-old male who was admitted to our hospital with cough for the previous two weeks. The chest CT demonstrated multiple variable sized mass-like consolidations with low density central necrosis in the peripheral portion of both the upper and lower lobes. Positron emission tomography (PET) showed multiple areas of hypermetabolic fluorodeoxyglucose (FDG) uptake in both lungs with central metabolic defects, which correlated with central necrosis seen on CT. The histological sample showed peripheral T-cell lymphoma of the not otherwise specified form. The follow-up CT scan showed an increased extent of the multifocal consolidative lesions despite that the patient had undergone chemotherapy.

Keyword

Lymphoma; T-cell; Peripheral

MeSH Terms

Contrast Media/diagnostic use
Cough/etiology
Diagnosis, Differential
Fatal Outcome
Fever/etiology
Fluorodeoxyglucose F18/diagnostic use
Follow-Up Studies
Humans
Lung/radiography/radionuclide imaging
Lung Neoplasms/complications/*radiography/*radionuclide imaging
Lymphoma, T-Cell/complications/*radiography/*radionuclide imaging
Male
Middle Aged
Pneumonia/complications
Positron-Emission Tomography/methods
Radiographic Image Enhancement/methods
Sweating
Tomography, X-Ray Computed/methods

Figure

• 

  Fig. 1 52-year-old male patient. A. On posteroanterior chest radiograph, variable sized large, round increased opacities are seen in both lower lobes and right upper lobe (arrow). Well defined linear increased opacity with architectural distortion is seen at posterior segment of left upper lobe. B-D. Contrast enhanced chest CT scan reveals variable sized masses in right upper lobe (B) and in both lower lobes (C, D) with portion of central necrosis. Small fluid collection is seen in left hemithorax (C, D). E. Percutaneous transthoracic needle biopsy specimen shows diffuse infiltrates of large atypical lymphoid cells (Hematoxylin & Eosin staining, ×100). F. Tumor cells are large with pleomorphic, irregular nuclei and prominent nucleoli (Hematoxylin & Eosin staining, ×400). G. Immunohistochemical staining of tumor cells revealed diffuse and strong positivity for cytoplasmic CD3 (Hematoxylin & Eosin staining, ×200). H. Staging whole torso PET scan revealed intensely hypermetabolic lung mass with central metabolic defects. There was no evidence of mediastinal lymph node uptake or extrapulmonary uptake. I-K. Contrast enhanced chest CT scan obtained two months after initial diagnosis shows that large mass in left lower lobe has increased in size with large areas of necrosis and multiple air spots (J). Multiple nodules with necrosis have increased in extent in right upper lobe and right lower lobe. Fluid collection in left hemithorax has increased in amount (I, K).

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