PMC9876723_01
Chest radiograph. Chest radiograph showing multiple ground-glass opacities in the bilateral lung fields.
1349-7235-62-0095-g001.jpg
PMC9876723_01_1349-7235-62-0095-g001.jpg
g001
Chest radiography (Fig. 1) showed multiple ground-glass opacities (GGOs) in the bilateral lung fields.
Chest high-resolution computed tomography. Chest high-resolution computed tomography showing multiple ground-glass opacities, nodules, and cyst formation in the bilateral lung fields (A). Five years later, the findings had gradually worsened (B).
1349-7235-62-0095-g002.jpg
PMC9876723_01_1349-7235-62-0095-g002.jpg
g002
Chest high-resolution computed tomography (CT) revealed multiple GGOs, nodules, and cyst formation in the bilateral lung fields (Fig. 2A). Five years later, a re-evaluation of the BALF for diffuse lung disease from the right B5 was performed because the radiological findings had gradually worsened with no remarkable change in her symptoms or lung function (Fig. 2B).
Pathological findings from the lung specimens. Low- (A) and high- (B, C) magnification photomicrographs of pathological specimens obtained during video-assisted thoracic surgery. Nodular lesions with fibrosis (A), lymphoid follicles with numerous germinal centers (B), and infiltration of plasma cells (C) were observed. Lymphoepithelial lesions were not observed.
1349-7235-62-0095-g003.jpg
PMC9876723_01_1349-7235-62-0095-g003.jpg
g003
A histopathological examination showed a nodular lesion with fibrosis, lymphoid follicles with numerous germinal centers, and infiltration of plasma cells (Fig. 3).
Analyses of the bronchoalveolar lavage fluid (BALF) with molecular biology techniques. (A) Negative results (nonclonal peaks) in the VH (FR1)/JH region for immunoglobulin heavy chain gene rearrangement for the evaluation of B-cell clonality using polymerase chain reaction (PCR). (B) Fusion signals of mucosa-associated lymphoid tissue 1 evaluated by fluorescence in situ hybridization with lymphocytes in BALF, suggesting no translocation of the specific gene of mucosa-associated lymphoid tissue lymphoma.
1349-7235-62-0095-g004.jpg
PMC9876723_01_1349-7235-62-0095-g004.jpg
g004
Polymerase chain reaction analyses of the VH (FR1)/JH, VH (FR2)/JH, VH (FR3)/JH, DH1-6/JH, and DH7/JH regions for IgH gene rearrangements for the evaluation of B-cell clonality and analysis for translocations of the mucosa-associated lymphoid tissue 1 gene (MALT1) at 18q21 and IgH at 14q32 in BALF via fluorescence in situ hybridization showed normal patterns (Fig. 4).