Pulmonary Involvement of Peripheral T-cell Lymphoma, Unspecified: A Case Report

Abstract

Peripheral T-cell lymphoma (PTCL) is a subtype of non-Hodgkin's lymphoma (NHL) and PTCL is quite rare in western countries: this accounting for 10 to 15% of all the case of NHL in Europe (1). Although PTCL may involve many organs, including the sino-nasal cavity and airway, intestinal tract, skin, lymph nodes and liver, it rarely involves the lung, and there are few radiological descriptions to guide making the proper diagnosis (2). We report here on a case of PTCL, unspecified (PTCL-U) that which did involve the lung parenchyma and mediastinal lymph nodes, and we present the clinical manifestations and pathological findings. Case ReportA 39-year-old man was admitted with a mild fever and cough of 3 days duration. The laboratory findings were an erythrocyte sedimentation rate (ESR) of 24 mm/hr, a C-reactive protein (CRP) level of 77 mg/L, the cytoplasmic antineutrophil cytoplasmic antibody (cANCA) was negative and the perinuclear anti-neutrophilic cytoplasmic antibody (pANCA) was negative. The chest radiography on admission revealed a cavitary lesion in the left middle lung zone (Fig. 1A). The chest CT image showed a thin-walled cavitary lesion in the superior segment of the left lower lobe (Fig. 1B). The upper level of the chest CT image, through the carina, revealed multiple lymphadenopathies in the mediastinum. The patient was treated with antibiotics and then he was discharged after the fever and cough had subsided.About 2 months later, the patient was readmitted to our hospital after 2 days of high fever. The laboratory findings were a white blood cell count of 14, 500/uL, a CRP level of 103 mg/L, the C-ANCA and P-ANCA were negative and the sputum acid-fast bacilli was negative. The antibody titer for Epstein-Barr virus was not elevated. Chest radiography showed an ill-defined consolidation in the left middle lung field and a prominent left hilum (Fig. 1C). The follow-up chest CT images showed a thick-walled cavity in the left lower lobe that was Peripheral T-cell lymphoma is a rare type of lymphoma that's derived from postthymic lymphoid T cells. Pulmonary involvement of peripheral T-cell lymphoma of the unspecified type is very rare and the imaging findings of this illness have rarely been reported. We present here a case of peripheral T-cell lymphoma of the unspecified type with a cavitary lesion in the lung parenchyma, and we pathologically confirmed this illness by performing video-assisted thoracoscopic surgery.