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Multiple cystic lung lesions and autoimmune thrombocytopaenia developing after chemotherapy for pulmonary indolent B-cell lymphoma with plasmacytic differentiation
  1. Hiroaki Tanaka1,
  2. Chihiro Kuwabara1,
  3. Yusuke Isshiki2 and
  4. Yoshio Suzuki3
  1. 1 Department of Hematology, Asahi General Hospital, Asahi, Chiba, Japan
  2. 2 Department of Hematology, Chiba University Hospital, Chiba, Chiba, Japan
  3. 3 Department of Pathology, Asahi General Hospital, Asahi, Chiba, Japan
  1. Correspondence to Dr Hiroaki Tanaka, htanaka{at}


Among lung malignancies, primary pulmonary lymphoma is rare and many of them are indolent B-cell lymphomas. We describe a case of primary pulmonary indolent B-cell lymphoma with plasmacytic differentiation, which exacerbated with the manifestation of macroglobulinaemia and was successfully treated using chemotherapy. The patient subsequently developed pulmonary cysts and thrombocytopaenia due to autoimmune pathology and was successfully treated using prednisolone. This case suggests that in indolent B-cell lymphoma with plasmacytic differentiation, immunoglobulin M level should be carefully followed even if it is within the normal range at lymphoma onset. Additionally, new cystic pulmonary infiltrates that develop during the post-treatment follow-up of an indolent pulmonary B-cell lymphoma may indicate pulmonary lymphoma recurrence, but there is also a possibility of an immunological complication.

  • haematology (incl blood transfusion)
  • respiratory medicine

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  • Patient consent for publication Obtained.

  • Contributors HT described this manuscript. HT, CK and YI treated this case and reviewed this paper. YS was responsible for pathological analysis and interpretation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.