PRIMARY EXTRANODAL NON-HODGKINS-LYMPHOMA OF THE LUNG PRESENTING WITH BILATERAL, PATCHY INFILTRATES DRAMATICALLY IMPROVING AFTER CORTICOSTEROID-THERAPY

A 63-year-old man was admitted to the hospital with fever and bilatera l, peripheral infiltrates. Infectious disease and malignancy seemed to be excluded by fiberoptic diagnostic procedures. Subsequently, respir atory insufficiency developed, making open lung biopsy impossible. The diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP) was strongly considered and treatment with corticosteroids was started; t his led to dramatic clinical and radiologic improvement for a short ti me. Eventually, an open lung biopsy specimen disclosed primary extrano dal non-Hodgkin's lymphoma of T-cell origin, immunoblastic, of high-gr ade malignancy according to the Kiel classification. After the first c ourse of chemotherapy, total respiratory insufficiency developed and t he patient died. This case is unique in a patient without AIDS.