Multiple pulmonary nodules presenting a difficult diagnostic challenge

https://doi.org/10.4081/monaldi.2020.1459

Authors

  • Martina Turrin | martinaturrin@gmail.com Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Italy. https://orcid.org/0000-0002-3062-6835
  • Mariaenrica Tinè Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Italy. https://orcid.org/0000-0002-3094-5721
  • Umberto Semenzato Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Italy. https://orcid.org/0000-0002-6739-8629
  • Manuel Cosio Meakins-Christie Laboratories and Respiratory Division, McGill University, Montreal, Canada.
  • Marina Saetta Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Italy. https://orcid.org/0000-0002-1547-2102
  • Kim Lokar Oliani Meakins-Christie Laboratories and Respiratory Division, McGill University, Montreal, Italy.

Abstract

We describe the case of a 56 years-old man with a subacute onset of symptoms mimicking a granulomatosis with polyangiitis. He was admitted to our hospital with acute respiratory failure requiring oxygen therapy, fever and crusted rhinitis. Despite initial improvement in radiological and clinical features with a steroids therapy, his condition worsened rapidly and he was re admitted to our department with ARDS. Despite antibiotic, antiviral and antifungal therapy, an endotracheal intubation was necessary and ultimately the patient passed away. Only a histological examination on autopsy had shown the presence of a diffuse Anaplastic Large Cell Lymphoma (ALCL), a rare type of non-Hodgkin lymphoma (NHL) originated from mature post-thymic T cells. It represents 1–3% of NHL. Different subtypes have been described: Kinase (ALK)-negative ALCL, ALK-positive ALCL and breast implantassociated ALCL. ALK-negative ALCL affects mainly old males and has the worst prognosis. 

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Published
2020-11-05
Info
Issue
Section
Pneumology - Case Reports
Keywords:
Granulomatosis with polyangiitis, anaplastic large cell lymphoma, pulmonary lymphomatoid granulomatosis
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  • PDF: 170
How to Cite
Turrin, Martina, Mariaenrica Tinè, Umberto Semenzato, Manuel Cosio, Marina Saetta, and Kim Lokar Oliani. 2020. “Multiple Pulmonary Nodules Presenting a Difficult Diagnostic Challenge”. Monaldi Archives for Chest Disease 90 (4). https://doi.org/10.4081/monaldi.2020.1459.