Case Report

A Case of Pulmonary Intravascular Lymphomatosis Diagnosed by Thoracoscopic Lung Biopsy
Toshiyuki Yamagata^a,c, Yukiharu Okamoto^a, Kiichiro Ota^a,b, Norifumi Katayama^b, Tadaaki Tsuda^b, Susumu Yukawa^c

Divisions of
^aClinical Oncology and Palliative Medicine,
^bBlood Transfusion and Clinical Hematology, and
^cDepartment of Internal Medicine, Wakayama Medical University, Wakayama, Japan

Address of Corresponding Author

Respiration 2003;70:414-418 (DOI: 10.1159/000072907)

  Key Words

• Intravascular lymphomatosis
• Primary pulmonary lesion
• Thoracoscopic lung biopsy
• Systemic chemotherapy
• Soluble interleukin-2 receptor

  Abstract

Intravascular lymphomatosis with primary pulmonary lesion is an extremely rare disease. Although the major clinical symptoms include fever, cough, dyspnea and loss of body weight, these are not diagnostic. Chest radiograph findings are also nonspecific and include bilateral reticular shadow, reticulonodular shadow, ground-glass opacity or wedge-shaped subpleural opacities. Therefore, the antemortem diagnosis is relatively difficult. It is considered that intravascular lymphomatosis is a high-grade malignant lymphoma. However, it has been shown recently that a good response and long-term survival may possibly be obtained through systemic combination chemotherapy. We report a case of intravascular lymphomatosis with primary pulmonary lesion where an early diagnosis was obtained through thoracoscopic lung biopsy and subsequent systemic chemotherapy proved to be quite effective. Because the clinical symptoms or chest radiograph findings are usually nonspecific, it was thought that thoracoscopic lung biopsy could be a useful procedure for early and reliable diagnosis of primary pulmonary intravascular lymphomatosis and that it might contribute to an improved prognosis.

Copyright © 2003 S. Karger AG, Basel

  Author Contacts

Toshiyuki Yamagata
Department of Internal Medicine, Wakayama Medical University
811-1, Kimiidera, Wakayama City
Wakayama 641-0012 (Japan)
Tel. +81 73 4410619, Fax +81 73 4462877, E-Mail y-toshi@wakayama-med.ac.jp

  Article Information

Received: January 18, 2002
Accepted: December 18, 2002
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 0, Number of References : 26