A Case of Peripheral T-cell Lymphoma with Diffuse Bilateral Pulmonary Infiltration and Whole Body Rash

양측 미만성 폐침윤과 전신 홍반을 동반한 말초 T세포 림프종

  • Lee, Seung Hyeun (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Ha, Eun Sil (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Jung Ha (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Jung, Jin Yong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Kyung Joo (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Se Joong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Eun Joo (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Hur, Gyu Young (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Jung, Ki Hwan (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Jung, Hye Cheol (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Sung Yong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Sang Yeub (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Je Hyeong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Shin, Chol (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Shim, Jae Jeong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • In, Kwang Ho (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kang, Kyung Ho (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Yoo, Se Hwa (Department of Internal Medicine, College of Medicine, Korea University)
  • 이승현 (고려대학교 의과대학 내과학교실) ;
  • 하은실 (고려대학교 의과대학 내과학교실) ;
  • 김정하 (고려대학교 의과대학 내과학교실) ;
  • 정진용 (고려대학교 의과대학 내과학교실) ;
  • 이경주 (고려대학교 의과대학 내과학교실) ;
  • 김세중 (고려대학교 의과대학 내과학교실) ;
  • 이은주 (고려대학교 의과대학 내과학교실) ;
  • 허규영 (고려대학교 의과대학 내과학교실) ;
  • 정기환 (고려대학교 의과대학 내과학교실) ;
  • 정혜철 (고려대학교 의과대학 내과학교실) ;
  • 이승룡 (고려대학교 의과대학 내과학교실) ;
  • 이상엽 (고려대학교 의과대학 내과학교실) ;
  • 김제형 (고려대학교 의과대학 내과학교실) ;
  • 신철 (고려대학교 의과대학 내과학교실) ;
  • 심재정 (고려대학교 의과대학 내과학교실) ;
  • 인광호 (고려대학교 의과대학 내과학교실) ;
  • 강경호 (고려대학교 의과대학 내과학교실) ;
  • 유세화 (고려대학교 의과대학 내과학교실)
  • Received : 2005.06.28
  • Accepted : 2005.09.14
  • Published : 2005.11.30

Abstract

Primary pulmonary non-Hodgkin's lymphoma (NHL) account for 0.4% of all types of lymphoma. Most cases are of the mucosa-associated lymphoid tissue (MALT) type, low grade B-cell lymphoma, but cases of the T-cell type are rare. The radiological findings frequently show hilar or mediastinal lymphadenopathy, but lung parenchymal involvement is uncommon. Here, a case of a patient, who presented with fever, generalized erythema, diffuse pulmonary infiltration and pleural effusion, diagnosed as a peripheral T-cell lymphoma, is reported.

폐에 발생하는 원발성 비호지킨 림프종은 아주 드문 질환으로 대개 폐문이나 중격동의 림프절 비대로 나타난다. 조직학적으로 대개 low grade B-cell 형태로 주로 발생하고 말초 T세포 형태로 폐에 원발성으로 발생하는 림프종은 드문 것으로 알려져 있다. 저자들은 발열과 전신 홍반이 있으면서, 흉부 X-선 사진상 급속히 진행하는 미만성 폐침윤 및 흉수 소견을 보여 초기에는 감염성 질환을 의심하였으나 피부병변과 림프절 및 골수 검사상 말초 T세포 림프종으로 진단된 예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Kuruvilla S, Gomthy DV, Shanthi AV, Thanasekharaan V, Deivanayagam CN. Primary pulmonary lymphoma: report of a case diagnosed by fine needle aspiration cytology. Acta Cytol 1994;38:601-4
  2. Fraser RG, Pare JA, Pars PD, Fraser RS, Genereux GP. Diagnosis of disease of the chest. 3rd ed. Philadelphia: WB Saunders: 1989. p. 1507
  3. Shim TS, Lim CM, Lee SD, Koh YS, Kim WS, Kim DS, et al. Pulmonary involvement of T-cell lymphoma with rapid, bilateral infiltration and high fever simulating pneumonia. Tuberc Respir Dis 1997;44:1440-6 https://doi.org/10.4046/trd.1997.44.6.1440
  4. Park SW, Kim JA, Jang JH, Jang J, Cheon JY, Kim SK. A case of primary pulmonary lymphoma of T-cell origin showing diffuse bilateral pulmonary infiltration. Korea J Med 1994;46:259-64
  5. Li G, Hansmann ML, Zwingers T, Lennert K. Primary lymphomas of the lung: morphological, immunohistochemical and clinical features. Histopathology 1990; 16:519-31 https://doi.org/10.1111/j.1365-2559.1990.tb01157.x
  6. Herbert A, Walters MT, Cawley MI, Godfrey RC. Lymphocytic interstitial pneumonia identified as lymphoma of mucosa associated lymphoid tissue. J Pathol 1985;146:129-38 https://doi.org/10.1002/path.1711460208
  7. Tamura A, Komatsu H, Yanai N, Homma J, Nagase A, Nemoto E, et al. Primary pulmonary lymphoma: relationship between clinical features and pathologic findings in 24 cases. Jpn J Clin Oncol 1995;25:140-52
  8. Ferraro P, Trastek VF, Adlakha H, Deschamps C, Allen MS, Pairolero PC. Primary non-Hodgkin's lymphoma of the lung. Ann Thorac Surg 2000;69:993-7 https://doi.org/10.1016/S0003-4975(99)01535-0
  9. Yu B, Kim NK, Kim KY, Han YC, Cho HI, Ham YK, et al. A case of lymphoma manifested as lymphocytic interstitial pneumonia. Korea J Med 1987;33:386-92
  10. Kim YK, Kim C, Jeon J, Jeon KW, Kim DW, Lee DW, et al. A case of primary pulmonary low-grade B-cell lymphoma of bronchus-associated lymphoid tissue with bilateral consolidation and indolent clinical course. Tuberc Respir Dis 1998;45:1073-81 https://doi.org/10.4046/trd.1998.45.5.1073
  11. Ueda T, Hosoki N, Isobe K, Yamamoto S, Motoori K, Shinkai H, et al. Diffuse pulmonary involvement by mycosis fungoides: high-resolution computed tomography and pathologic findings. J Thorac Imaging 2002;17:157-9 https://doi.org/10.1097/00005382-200204000-00009
  12. Kim JH, Lee SH, Park J, Kim HY, Lee SI, Park JO, et al. Primary pulmonary non-Hodgkin's lymphoma. Jpn J Clin Oncol 2004;34:510-4 https://doi.org/10.1093/jjco/hyh095
  13. Long JC, Mihm MC. Mycosis fungoides with extracutaneous dissemination: a distinct clinicopathologic entity. Cancer 1974;34:1745-55 https://doi.org/10.1002/1097-0142(197411)34:5<1745::AID-CNCR2820340524>3.0.CO;2-W
  14. Foster GH, Eichenhorn MS, van Slyck EJ. The Sezary syndrome with rapid pulmonary dissemination. Cancer 1985;56:1197-8 https://doi.org/10.1002/1097-0142(19850901)56:5<1197::AID-CNCR2820560538>3.0.CO;2-H
  15. Fredman AS. Malignancies of lymphoid cells. Harrison's online version 2.0. 2001. p. 25