TY - JOUR
T1 - Rare case of pulmonary lymphomatoid granulomatosis in conjunction with tuberculosis
AU - Ha, Young Woo
AU - Kim, Chul Hwan
AU - Park, Yong
AU - Sohn, Jang Wook
AU - Kim, Min Ja
AU - Yoon, Young Kyung
N1 - Publisher Copyright:
© 2017 the Author(s).
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Rationale: Lymphomatoid granulomatosis is a very rare Epstein-Barr virus-driven lymphoproliferative disease. This disease has high mortality owing to its low incidence in conjunction with nonspecific presentations, which contribute to delays in diagnosis. Patient: An 87-year-old male had a week-long history of intermittent fever and general weakness. A chest radiograph showed multifocal patchy consolidations with nodular lesions. Diagnoses: Open lung biopsy using video-assisted thoracic surgery resulted in a diagnosis of grade III lymphomatoid granulomatosis. Three days after surgery, Mycobacterium tuberculosis complex was identified from the culture of sputum samples collected at admission. Intervention and outcomes: Antituberculous treatment was commenced first. However, after 34 days of antituberculosis medication, the patient died owing to aggravated lymphomatoid granulomatosis. Lessons: This case highlights the fact that rare diseases should also be considered in differential diagnosis, particularly with a common presentation such as multiple lung nodules. Furthermore, a diagnosis of pulmonary lymphomatoid granulomatosis was made after open lung biopsy. To our knowledge, this is the first case of lymphomatoid granulomatosis coexisting with active tuberculosis in the Republic of Korea, where tuberculosis is endemic.
AB - Rationale: Lymphomatoid granulomatosis is a very rare Epstein-Barr virus-driven lymphoproliferative disease. This disease has high mortality owing to its low incidence in conjunction with nonspecific presentations, which contribute to delays in diagnosis. Patient: An 87-year-old male had a week-long history of intermittent fever and general weakness. A chest radiograph showed multifocal patchy consolidations with nodular lesions. Diagnoses: Open lung biopsy using video-assisted thoracic surgery resulted in a diagnosis of grade III lymphomatoid granulomatosis. Three days after surgery, Mycobacterium tuberculosis complex was identified from the culture of sputum samples collected at admission. Intervention and outcomes: Antituberculous treatment was commenced first. However, after 34 days of antituberculosis medication, the patient died owing to aggravated lymphomatoid granulomatosis. Lessons: This case highlights the fact that rare diseases should also be considered in differential diagnosis, particularly with a common presentation such as multiple lung nodules. Furthermore, a diagnosis of pulmonary lymphomatoid granulomatosis was made after open lung biopsy. To our knowledge, this is the first case of lymphomatoid granulomatosis coexisting with active tuberculosis in the Republic of Korea, where tuberculosis is endemic.
KW - Epstein-Barr virus
KW - pulmonary lymphomatoid granulomatosis
KW - pulmonary tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85032620607&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000008323
DO - 10.1097/MD.0000000000008323
M3 - Article
C2 - 29049243
AN - SCOPUS:85032620607
VL - 96
JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
SN - 0025-7974
IS - 42
M1 - e8323
ER -