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Cho, Yang, Yu, Soe, Kim, and Sheen: A Case of Low-grade B-cell Lymphoma of Bronchial Associated Lymphoid Tissue Mimicking Lipoid Pneumonia
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(2): 194-199.

Published online: 31 August 2007

DOI: https://doi.org/10.4046/trd.2007.63.2.194

A Case of Low-grade B-cell Lymphoma of Bronchial Associated Lymphoid Tissue Mimicking Lipoid Pneumonia

Jin Hee Cho, M.D.1, Min Jae Yang, M.D.1, Su Kyong Yu, M.D.1, Kyoung Woo Soe, M.D.1, Hugh Chul Kim, M.D.2, Seung Soo Sheen, M.D.1

1Department of Pulmonary and Critical Care Medicine, Ajou University School of Medine, Suwon, Korea.

2Department of Hemato-oncology, Ajou University School of Medine, Suwon, Korea.

Address for correspondence: Seung Soo Sheen, M.D. Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Wonchon-dong, Suwon, 443-721, Korea. Phone: 82-31-219-5122, Fax: 82-31-219-5124, sssheen@ajou.ac.kr

Received 14 June 2007       Accepted 6 August 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.

Keywords: BALT lymphoma, Marginal zone lymphoma, Non-Hodgikin's lymphoma, Lipoid pneumonia

Figures and Tables

Figure 1
Chest radiography shows the aggravated consolidation compared with previous study in right middle lobe, left lingular division and both lower lobes.
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Figure 2
CT scan shows aggravated air-space consolidation , ground glass opacities with interstitial thickening of interlobular septa in right middle lobe, left lingular division and both lower lobes.
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Figure 3
Light scopic study shows diffuse infiltration of the small round atypical lymphoid cells in alveolar space.
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Figure 4
Immunohistochemical stain for CD 20 shows positive reation reactivity (×400).
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Figure 5
Immunohistochemical stain for CD 5 shows negative reation (×400).
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Figure 6
PET CT shows multiple FDG uptake in right middle lobe, left lingular division, both lower lobe, both hilar, right paratracheal and subcarinal lymph node.
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Figure 7
PET CT shows the decreased FDG uptake compared with previous study in right middle lobe and leff lingular division. The subcarinal lymph node is disappeared in FDG uptake after 6th chemotherapy.
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