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Diffuse Lung Disease |

Lymphomatoid Granulomatosis FREE TO VIEW

Alina Pirvu, RPh; Claudia Toma, MD; Ionela Belaconi, MD; Miron Alexandru Bogdan, MD
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National Institute of Pneumology Mariu Nasta, Bucharest, Romania


Chest. 2014;145(3_MeetingAbstracts):219A. doi:10.1378/chest.1836469
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Abstract

SESSION TITLE: ILD Case Report Posters II

SESSION TYPE: Case Report Poster

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

INTRODUCTION: Lymphomatoid granulomatosis is a rare lymphoproliferative angio destructive disease associated systemic Epstein-Barr virus infection, characterized by predominant pulmonary involvement and extrapulmonary too, with uncertain malignant potential.

CASE PRESENTATION: We present the case of an older pacient non smoker , without occupational exposure to respiratory hazards admitted to our clinic for the etiological diagnosis of bilateral pulmonary opacities discovered after an X-ray associating medium dyspnea, asthenia of approximately 2 weeks and weight loss(10 pound /in one year). The physical exam shows a general condition perishable, , bilateral decreased vesicular murmur, 97% oxygen saturation and heart rate 55b/min. Biologically-nonspecific inflammatory syndrome, thrombocytopenia, mild nitrogen retention. Bronchoscopy revealed no proliferative elements in the explored areas and the bronchiolo-alveolar lavage revealed neutrophil almost 91 per cent. So at this moment we didn’t have a certain diagnose so we decided to make an surgical biopsy that raised suspicion of Hodgkin's disease but immunohistochemical tests refuted this diagnostic hypothesis pleading for reactive inflammatory lesion character-Lymphomatoid granulomatosis. . He followed corticosteroids treatment 3 months in which the pulmonary tumors decreased in size.

DISCUSSION: This condition can develop into severe lymphoma in 13-47% of cases and may progress to severe respiratory failure, pneumothorax, infection, hemoptysise so it is very important to have a certain diagnose as quick as possible.

CONCLUSIONS: This disease is usually progressive and fatal. The mortality rate varies from 63-90% at 5 years, however the clinical course is variable reported prolonged disease and spontaneous resolution

Reference #1: Lymphocytic interstitial pneumonia and other lymphoproliferative Disorders in the long run. Nicholson AG Semin Respir Crit Care Med. 2001 22 (4): 409)

DISCLOSURE: The following authors have nothing to disclose: Alina Pirvu, Claudia Toma, Ionela Belaconi, Miron Alexandru Bogdan

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