Es. Boon et al., PRIMARY EXTRANODAL NON-HODGKINS-LYMPHOMA OF THE LUNG PRESENTING WITH BILATERAL, PATCHY INFILTRATES DRAMATICALLY IMPROVING AFTER CORTICOSTEROID-THERAPY, Chest, 104(4), 1993, pp. 1292-1293
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.