PMC7658487_01
High resolution CT shows a diffuse a ground-glass nodule in the lower lobe of the right lung near the seventh to ninth thoracic vertebrae (arrow).
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Her chest CT showed a ground glass nodule with a diameter of 1.5cm in the lower lobe (S6) of the right lung (Fig. 1).
Histological findings of the resected lung.. (A) The lung tissue shows diffuse lymphoid follicular hyperplasia, lymphocyte infiltration in the alveolar septum, and macrophage and lymphocyte exudation in the alveolar space (HE stain, original magnification, x 10). (B) The lung tissue shows small lymphocytes, plasma cell infiltration, and follicular bronchiolitis in the alveolar septum (HE stain, original magnification, x 40). A: Artery, pulmonary RB: Respiratory bronchiole.
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For a definitive diagnosis, video-assisted thoracoscopic surgery was performed, and the pathological findings showed diffuse lymphoid follicular hyperplasia, infiltration of the alveolar septum by small lymphocytes and plasma cells, and follicular bronchiolitis (Fig. 2A). There were many lymphoid follicles in the tissue and lymphocyte exudation was present in the alveolar space (Fig. 2B).
Photomicrographs of immunostained lung tissue.. The follicular area was CD20 positive and alveolar septal lymphocytes were CD3 positive (original magnification, x 40).
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T cells had infiltrated into the alveolar walls (Fig. 3).
After 7 months, high resolution CT showed a ground glass shadow on the dorsal side of the left lower lung field.
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Seven months after surgery, new localized ground glass shadows appeared (Fig. 4), and they gradually increased on the basal lesion of the lung for four years (Fig. 5).