Pulmonary Intravascular Large B-cell Lymphoma (IVLBCL) Disguised as an Asthma Exacerbation in a Patient with Asthma
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- Takeshige Tomohito
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Harada Norihiro
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Sekimoto Yasuhito
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Kanemaru Ryota
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Tsutsumi Takeo
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Matsuno Kei
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Shiota Satomi
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Masuda Azuchi
- Department of Hematology, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Gotoh Akihiko
- Department of Hematology, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Asahina Miki
- Department of Human Pathology, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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- Uekusa Toshimasa
- Department of Pathology, Labour Health and Welfare Organization Kanto Rosai Hospital, Japan
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- Takahashi Kazuhisa
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Japan
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抄録
<p>A 62-year-old man with asthma presented with a 1-month history of wheezing and exertional dyspnea. Although the wheezing symptoms disappeared after systemic corticosteroid therapy, the exertional dyspnea and hypoxemia did not improve. A diagnosis of intravascular large B-cell lymphoma (IVLBCL) with pulmonary involvement was suspected because of the increased serum lactic dehydrogenase (LDH) and soluble interleukin-2 receptor (sIL-2R) level, increased alveolar-arterial oxygen difference (AaDO2), decreased pulmonary diffusing capacity for carbon monoxide (DLCO) and scintigraphic, computed tomography (CT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT findings. The patient was diagnosed as having IVLBCL with pulmonary involvement based on a pathological analysis of a random skin biopsy and a transbronchial lung biopsy. IVLBCL should be considered in patients with symptoms of asthma that are refractory to corticosteroid treatment. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 56 (14), 1885-1891, 2017
一般社団法人 日本内科学会