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Case Reports: Rare disease
Pulmonary lymphomatoid granulomatosis in a patient with long-term use of a tumour necrosis factor-α inhibitor
  1. Matsuo So1,
  2. Tal Shachi2,
  3. Jeremy Mudd3,
  4. Lina Miyakawa4 and
  5. Boram Kim4
  1. 1 Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  2. 2 Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Morningside, Mount Sinai West, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  3. 3 Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  4. 4 Deparment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  1. Correspondence to Dr Matsuo So; so.matuo{at}gmail.com

Abstract

A man in his 60s presented with intermittent constitutional symptoms along with waxing and waning chest radiographic abnormalities, eventually leading to a diagnosis of lymphomatoid granulomatosis (LYG). LYG is a rare, progressive Epstein–Barr virus (EBV)-driven lymphoproliferative disease associated with immune dysregulation most commonly involving the lungs. The diagnosis requires tissue biopsy; thus, the decision to pursue tissue sampling with histopathology examination in a timely manner is essential. Currently, there are no established guidelines regarding the treatment of LYG, which varies from cessation of immunosuppressants to immunochemotherapy and usually requires multidisciplinary team discussion.

  • Malignant and Benign haematology
  • Pulmonary embolism
  • Interstitial lung disease

http://dx.doi.org/10.1136/bcr-2022-254211

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    Footnotes

    • Twitter @SoMatsuo

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: MS, TS, JM. The following authors gave final approval of the manuscript: LM, BK.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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