J Korean Soc Radiol.  2011 Feb;64(2):147-150. 10.3348/jksr.2011.64.2.147.

Non-Hodgkin's Lymphoma Presenting as an Endobronchial Polypoid Mass: A Case Report

Affiliations
  • 1Department of Radiology, Dong-A University College of Medicine, Busan, Korea. gnlee@donga.ac.kr
  • 2Department of Pathology, Dong-A University College of Medicine, Busan, Korea.

Abstract

Non-Hodgkin's lymphoma seldom, if ever, involves the tracheobronchial tree, and it manifests as a diffuse infiltrating pattern with clinically apparent systemic lymphoma. Endobronchial involvement presenting as an endobronchial polypoid mass is far rarer. We report here on a case of diffuse large B-cell non-Hodgkin lymphoma that presented as an endobronchial polypopid mass obstructing the central bronchi and this led to lobar atelectasis.


MeSH Terms

B-Lymphocytes
Bronchi
Bronchial Neoplasms
Lymphoma
Lymphoma, Non-Hodgkin
Pulmonary Atelectasis
Tracheal Neoplasms

Figure

  • Fig. 1 An 82-year-old man with endobronchial non-Hodgkin's lymphoma. A. A chest radiograph showed a left hilar mass (arrow) with obstructive pneumonia of the left upper lobe. Ill-defined increase opacity in the left upper lung zone is accompanied by elevation of the left hilum and the left sided juxtaphrenic peak. B, C. The axial unenhanced (B) and enhanced (C) CT scans obtained at the carinal level show a 2 × 1 cm sized intraluminal protruding mass with homogeneous enhancement (arrow) in the left upper lobe bronchus, and this is accompanied by partial atelectasis of the left upper lobe and enlarged precarinal lymph nodes. D. Bronchoscopy reveals a polypoid fleshy mass incompletely obstructing the left upper lobe bronchus (arrow). E. The microscopic photograph shows a diffuse proliferation of atypical lymphocytes with pleomorphic hyperchromatic nuclei overlying the ciliated pseudostratified columnar epithelium (H & E, ×200). F. PET/CT shows a high metabolic rate in the endobronchial lesion, in both the interlobar and lobar lymph nodes and the lung parenchyma in the left lower lobe. The focal area of ground-glass opacity in the left lower lobe also reveals mild uptake.


Reference

1. Park CM, Goo JM, Lee HJ, Kim MA, Lee CH, Kang MJ. Tumors in the tracheobronchial tree: CT and FDG PET Features. Radiographics. 2009; 29:55–71.
2. Rose RM, Grigas D, Strattemeir E, Harris NL, Linggood RM. Endobronchial involvement with non-Hodgkin's lymphoma. Cancer. 1986; 57:1750–1755.
3. Mason AC, White CS. CT appearance of endobronchial non-Hodgkin lymphoma. J Comput Assist Tomogr. 1994; 18:559–561.
4. Kilgore TL, Chasen MH. Endobronchial non-Hodkin's lymphoma. Chest. 1983; 84:58–61.
5. Fidias P, Wright C, Harris NL, Urba W, Grossbard ML. Primary tracheal non-Hodkin's lymphoma. Cancer. 1996; 77:2332–2338.
6. Pilichowska M, Klepper S, Campbell G, Klein A, Ernest A, Finlay G. A 64-year-old woman with cough and right middle lobe collapse. Chest. 2007; 132:1691–1696.
7. Jang M, Choi YW, Jeon SC, Park C, Yoon HJ. Endobronchial non-Hodgkin's lymphoma presenting as an isolated endobronchial mass. Clin Radiol. 2006; 61:202–205.
8. Solomonov A, Zuckerman T, Goralnik L, Ben-Arieh Y, Rowe JM, Yigla M. Non-Hodgkin's lymphoma presenting as an endobronchial tumor: report of eight cases and literature review. Am J Hematol. 2008; 83:416–419.
9. Eng J, Sabanathan S. Endobronchial non-Hodgkin's lymphoma. J Cardiovasc Surg. 1993; 34:351–354.
10. Kaira K, Ishzuka T, Tanaka H, Tanaka Y, Ishzuka T, Yanagitani N, et al. B-cell non-Hodgin lymphoma presenting as an endobronchial polypoid mass. J Thorac Oncol. 2008; 3:530–531.
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