PMC5548684_01
Chest CT (A) and 18F-FDG PET-CT (B) scans at the initial presentation, showing diffuse multiple small nodules in the lung fields and an increased diffuse FDG uptake in both middle-lower lung fields. FDG: fluorodeoxyglucose, PET: positron emission tomography
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Although chest X-ray showed no abnormal findings, chest CT showed diffuse multiple small nodules in the lung fields, no mass and no lymphadenopathy in the thorax or the abdominal cavity (Fig. 1A). A diffuse pulmonary 18F-FDG PET-CT scan showed an increased diffuse FDG uptake in both middle-lower lung fields (Fig. 1B).
A histopathological analysis of random skin (A, B and C) and transbronchial lung (D, E and F) biopsy specimens. Atypical lymphoid cells were seen in the intravascular space of capillary vessels and pulmonary artery (Hematoxylin and Eosin staining, x400) (A and D). These cells were positive for CD20 (B and E) and CD79a (C and F) (CD20 and CD79a immunostaining, x400).
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B-cell markers (Fig. 2), and demonstrated a high proliferation index, as revealed by MIB-1 (Ki-67) (data not shown). Based on these results, the patient was diagnosed as having IVLBCL with pulmonary involvement.
Chest CT (A) and 18F-FDG PET-CT (B) scans after the completion of eight courses of R-CHOP. Diffuse multiple small nodules and the diffuse FDG uptake disappeared completely in the lung fields on CT and FDG-PET/CT findings, respectively. FDG: fluorodeoxyglucose, PET: positron emission tomography
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He achieved complete remission after eight cycles of R-CHOP chemotherapy with no severe adverse events, and the LDH and sIL-2R levels, the AaDO2 and chest CT and FDG-PET findings subsequently revealed no signs of lymphoma involvement (Fig. 3).