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Lung Cancer |

Primary Pulmonary T-Cell Lymphoblastic Lymphoma With Pleural Metastasis in a Young Male Patient

Bhavesh Vaghani, MBBS; Rajesh Swarnakar, CCP; Dr. Jitendra Hazare, MS; Sheetal Sinha, MBBS
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KRIMS Hospital, Nagpur, India


Chest. 2014;145(3_MeetingAbstracts):300A. doi:10.1378/chest.1823740
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Abstract

SESSION TITLE: Cancer Case Report Posters I

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM

INTRODUCTION: Primary pulmonary non-Hodgkin’s lymphoma is a rare diagnosis. Most of the cases originate from B cell lineage and arise from mucosa associated lymphoid tissue of the bronchus. Very few cases of primary pulmonary T-cell lymphoma have been reported. We report here an extremely rare case of primary pulmonary precursor T-cell lymphoblastic lymphoma with Pleural metastasis in a 16 year old male adolescent.

CASE PRESENTATION: A 16 year old male patient presented to us with complaints of cough and low grade fever of 3 months duration and exertion dyspnea of 1 month duration & was on empirical anti TB therapy since a month. He was a tobacco chewer since age 11. Clinical Examination & CXR revealed pacified left lung field. CT Chest done showed large left lung mass extending into right lung via mediastinum with left sided pleural effusion. Thoracoscopy showed multiple nodular growths over both parietal and visceral pleura along with huge left lung mass. Thoracoscopic lung & pleural biopsy revealed high grade Non- Hodgkin’s Lymphoma. Immunohistochemical staining demonstrated that tumor cells were positive for CD3, CD10 and KI-67 and were negative for CD 20 and CD34. Pathological diagnosis was primary pulmonary T-cell precursor lymphoblastic lymphoma. Patient died soon thereafter before we could offer him any therapy.

DISCUSSION: Primary pulmonary T-cell lymphoma is a rare diagnosis with only 13 cases reported in the world. Patients were usually elderly with females were affected twice than males. The most common radiographic finding was bilateral diffuse nodular lesions. Our case showed very unusual features, hitherto unrepresented in literature like our patient was male adolescent with lung mass and metastasis showing immunohistochemistry features of rare T cell Lymphoma. He probably presented to us in very late stage with metastasis and represents natural history of such untreated cases.

CONCLUSIONS: T cell precursor lymphoblastic lymphoma of the lung is very unusual diagnosis. To our knowledge we report the first case of Primary Pulmonary T-cell precursor lymphoblastic lymphoma in a young male with metastasis in pleura.

Reference #1: Chung H, Sang H, Jai S, Hee K, Sung I, Jang G, Eun S. Primary Pulmonary T-Cell Lymphoma: a Case Report. Korean J Radiol. 2010 Mar-Apr; 11(2): 234-238.

Reference #2: Laohaburanakit P, Hardin K. NK/T cell lymphoma of the lung: a case report and review of literature. Thorax. 2006 March; 61(3): 267-270.

Reference #3: Fishman A, Elias J, Fishman J, Grippi M, Senior R, Pack A. Fishman's pulmonary diseases and disorders, Fourth Edition. Volume 2. 2007, 1955-60.

DISCLOSURE: The following authors have nothing to disclose: Bhavesh Vaghani, Rajesh Swarnakar, Dr. Jitendra Hazare, Sheetal Sinha

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