Pulmonary intravascular large B-cell lymphoma misdiagnosed as allergic pneumonia: a case report and literature review - PubMed
4 days ago
- #PIVLBCL
- #TBCB
- #misdiagnosis
- Pulmonary intravascular large B-cell lymphoma (PIVLBCL) is a rare subtype of diffuse large B-cell lymphoma affecting lung blood vessels.
- A 51-year-old female hairdresser with occupational hair dye exposure was initially misdiagnosed with chronic bronchitis and later hypersensitivity pneumonitis due to nonspecific radiological findings.
- Transbronchial lung cryobiopsy (TBCB) confirmed PIVLBCL, showing intravascular lymphoid proliferation (CD20+/BCL-6+/Ki-67��80%).
- Treatment with R-CHOP chemotherapy led to complete remission and improved lung function (DLCO increased to 68% predicted at 6 months).
- Literature review of 75 PIVLBCL cases revealed fever (74.7%) and dyspnea (65.3%) as common symptoms, with frequent misdiagnosis as interstitial lung disease (31.8%) or pneumonia (31.8%).
- Ground-glass opacities (GGOs) were observed in 54.7% of cases, often leading to misdiagnosis.
- TBCB is clinically useful for diagnosing ambiguous pulmonary opacities and should be considered when diffuse GGOs with isolated DLCO reduction are present.