PRIMARY NON-HODGKINS-LYMPHOMA OF THE LUNG PRESENTING AS BRONCHIOLITISOBLITERANS ORGANIZING PNEUMONIA

A 44-year-old man presented with fever, dyspnea, and bilateral cavitar y lung lesions. Following percutaneous transthoracic CT guided needle biopsy of the lung, a diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP) was made and the patient was treated with corticoste roids. Despite a good initial response he developed new lung lesions w ithin six months, associated with a lack of response to corticosteroid s. Due to further deterioration and the development of Guillian-Barre' syndrome an open lung biopsy was performed and revealed T-cell rich, B-cell non Hodgkin's lymphoma with BOOP. We suggest that BOOP may be t he presenting manifestation of primary lung lymphoma. We recommend tha t when BOOP has an atypical course or does not respond to corticostero ids open lung biopsy should be performed in order to exclude pulmonary lymphoma.