Pulmonary intravascular lymphomatosis: Presentation with dyspnea and air trapping

Jeffrey G. Walls, Y. Gia Hong, Joseph E. Cox, Kevin M. McCabe, Kevin E. O'Brien, Jeffrey P. Allerton, Stephen Derdak

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Intravascular lymphomatosis (IVL) is a rare lymphoid neoplasm that is typically of B-cell lineage and characterized by proliferation of malignant cells within small arterioles, capillaries, and venules. We report a patient with pulmonary IVL who presented clinically with progressive dyspnea, fever, and a dry cough. Pulmonary function tests revealed a marked decrease in diffusion capacity with airflow obstruction and severe air trapping. High- resolution CT (HBCT) of the chest with inspiratory and expiratory images revealed mosaic attenuation consistent with air trapping. Transbronchial biopsies revealed the diagnosis of IVL with capillary expansion in the alveolar and peribronchiolar interstitial tissue. IVL should be considered in the differential diagnosis of a patient with an interstitial lung disease, air trapping on pulmonary function tests, and mosaic attenuation on HRCT. Transbronchial biopsies may be the initial diagnostic procedure of choice.

Original languageEnglish (US)
Pages (from-to)1207-1210
Number of pages4
JournalChest
Volume115
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

Keywords

  • Air trapping
  • High-resolution CT
  • Intravascular lymphomatosis
  • Mosaic perfusion

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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