Caso Clínico/Case Report
Linfoma intravascular do pulmão: A propósito de um caso clínico com boa resposta à terapêutica
Intravascular pulmonary lymphoma with good response to treatment. A case report
M. Felizardo1,
, A.C. Mendes2, A. Fernandes3, P. Campos4, V. Magalhães2, I. Correia2, A. Pignatelli5, C. Ferreira6, R. Sotto-Mayor7, A Bugalho de Almeida8
Corresponding author
margaridafelizardo@yahoo.com
Correspondência / Correspondence to: Margarida Felizardo, Hospital de Santa Maria CHNL, EPE, Avenida Prof. Egas Moniz, Lisboa, Portugal
Correspondência / Correspondence to: Margarida Felizardo, Hospital de Santa Maria CHNL, EPE, Avenida Prof. Egas Moniz, Lisboa, Portugal
1 Interna do Internato Complementar de Pneumologia / Resident, Specialist training in Pulmonology
2 Assistente Hospitalar Graduada de Pneumologia / Consultant, Pulmonology specialist
3 Director do Serviço de Anatomia Patológica. Professor Graduado da Faculdade de Medicina de Lisboa / Director, Anatomo-Pathology Unit. Specialist professor, Lisbon University School of Medicine
4 Assistente Hospitalar Graduada de Imagiologia / Consultant, Radiology specialist
5 Interna do Internato Complementar de Anatomia Patológica / Resident, Specialist training in Anatomo-Pathology
6 Assistente Hospitalar de Anatomia Patológica / Consultant, Anatomo-Pathology
7 Chefe de Serviço de Pneumologia. Assistente convidado da Faculdade de Medicina de Lisboa / Head, Pulmonology Unit. Guest assistant professor Lisbon University School of Medicine
8 Director do Serviço de Pneumologia. Professor da Faculdade de Medicina de Lisboa / Director, Pulmonology Unit, Specialist professor, Lisbon University School of Medicine
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Assistente convidado da Faculdade de Medicina de Lisboa / <span class="elsevierStyleItalic">Head, Pulmonology Unit. Guest assistant professor Lisbon University School of Medicine</span>" "etiqueta" => "7" "identificador" => "af0035" ] 7 => array:3 [ "entidad" => "Director do Serviço de Pneumologia. Professor da Faculdade de Medicina de Lisboa / <span class="elsevierStyleItalic">Director, Pulmonology Unit, Specialist professor, Lisbon University School of Medicine</span>" "etiqueta" => "8" "identificador" => "af0040" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleBold">Correspondência / <span class="elsevierStyleItalic">Correspondence to:</span></span> Margarida Felizardo, Hospital de Santa Maria CHNL, EPE, Avenida Prof. Egas Moniz, Lisboa, Portugal" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Intravascular pulmonary lymphoma with good response to treatment. A case report" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-08-24" "fechaAceptado" => "2008-09-13" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570071" "palabras" => array:4 [ 0 => "Linfoma" 1 => "intravascular" 2 => "febre" 3 => "pulmonar" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570070" "palabras" => array:4 [ 0 => "Lymphoma" 1 => "intravascular" 2 => "fever" 3 => "pulmonary" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">O linfoma intravascular é uma forma muito rara de linfoma não Hodgkin de células grandes B. Caracte-riza-se pela proliferação celular tumoral de linfócitos limitada aos pequenos vasos, particularmente nos capilares. Apresentamos o caso de uma doente de 54 anos, não fumadora, que foi admitida no nosso hospital para investigação de um quadro com quatro meses de evolução de febre, sudorese nocturna, emagrecimento não quantificado e dispneia progressiva. Ao exame objectivo apresentava-se febril, taquicárdica e polipneica. Analiticamente, destacava-se anemia, leucocitose e LDH elevada. Gasometria arterial -FiO<span class="elsevierStyleInf">2</span> 1<span class="elsevierStyleHsp" style=""></span>l/m: PaO<span class="elsevierStyleInf">2</span>-63,6<span class="elsevierStyleHsp" style=""></span>mm Hg. A telerradiografia de tórax revelava infiltado intersticial difuso. Foram excluídas todas as causas de febre de origem indeterminada. O diagnóstico foi realizado por biópsia pulmonar cirúrgica e foi prescrita terapêutica citostática combinada e rituximab com boa resposta clínica. Relatamos o caso pela dificuldade diagnóstica e pela boa resposta à terapêutica.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (6): 857-868</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Intravascular lymphoma is a very rare form of large B cell non-Hodgkin’s lymphoma, characterised by the presence of lymphoma cells in the lumina of small vessels only, particulary in the capillaries. We report a 54 year-old female non-smoker, admitted to hospital for further examination of a four month long clinical condition involving high fever, night sweats, unqualified weight loss and progressive dyspnea. Patient’s temperature was 38.5<span class="elsevierStyleHsp" style=""></span>ºC, pulse 100/min and respiratory 22 cycles/min.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Patient’s haemoglobin was 9.4<span class="elsevierStyleHsp" style=""></span>g/dL, she had leukocytosis, elevated LDH and arterial blood gas analysis with moderate hypoxaemia (FiO<span class="elsevierStyleInf">2</span> 1<span class="elsevierStyleHsp" style=""></span>l/m: PaO<span class="elsevierStyleInf">2</span>-63.6<span class="elsevierStyleHsp" style=""></span>mm Hg). Chest X-ray revealed diffuse interstitial changes. All the possible causes of unknown origin fever were excluded.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Diagnosis was made through lung biopsy and treatment with combined chemotherapy and rituximab was prescribed leading to a 48 hours clinical remission. We present this case to show how difficult this diagnosis can be and how a good response to therapy is possible.</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (6): 857-868</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bilbiografia / Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravascular lymphomatosis diagnosed by transbronchial lung biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:9 [ 0 => "K. Takamura" 1 => "Y. Nasuhara" 2 => "T. Mishina" 3 => "T. Matsuda" 4 => "M. Nishimura" 5 => "Y. Kawakami" 6 => "M. Fujita" 7 => "C. Mikuni" 8 => "K. 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Go" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Histopathology" "fecha" => "1997" "volumen" => "31" "paginaInicial" => "555" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9447388" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673608602032" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001400000006/v1_201509151433/S0873215915302919/v1_201509151433/pt/main.assets" "Apartado" => array:4 [ "identificador" => "9580" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Casos clínicos" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001400000006/v1_201509151433/S0873215915302919/v1_201509151433/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915302919?idApp=UINPBA00004E" ]
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ISSN: 08732159Original language: Portuguese
The statistics are updated each day
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 4 | 8 |
| 2024 October | 46 | 33 | 79 |
| 2024 September | 37 | 33 | 70 |
| 2024 August | 57 | 58 | 115 |
| 2024 July | 39 | 43 | 82 |
| 2024 June | 41 | 40 | 81 |
| 2024 May | 34 | 40 | 74 |
| 2024 April | 42 | 34 | 76 |
| 2024 March | 31 | 26 | 57 |
| 2024 February | 37 | 29 | 66 |
| 2024 January | 17 | 38 | 55 |
| 2023 December | 21 | 40 | 61 |
| 2023 November | 25 | 24 | 49 |
| 2023 October | 29 | 32 | 61 |
| 2023 September | 27 | 45 | 72 |
| 2023 August | 18 | 26 | 44 |
| 2023 July | 23 | 39 | 62 |
| 2023 June | 20 | 26 | 46 |
| 2023 May | 29 | 28 | 57 |
| 2023 April | 24 | 21 | 45 |
| 2023 March | 22 | 22 | 44 |
| 2023 February | 25 | 24 | 49 |
| 2023 January | 31 | 28 | 59 |
| 2022 December | 35 | 26 | 61 |
| 2022 November | 67 | 47 | 114 |
| 2022 October | 38 | 33 | 71 |
| 2022 September | 53 | 44 | 97 |
| 2022 August | 27 | 59 | 86 |
| 2022 July | 26 | 36 | 62 |
| 2022 June | 20 | 29 | 49 |
| 2022 May | 34 | 33 | 67 |
| 2022 April | 23 | 32 | 55 |
| 2022 March | 20 | 34 | 54 |
| 2022 February | 26 | 30 | 56 |
| 2022 January | 35 | 63 | 98 |
| 2021 December | 17 | 39 | 56 |
| 2021 November | 32 | 39 | 71 |
| 2021 October | 32 | 44 | 76 |
| 2021 September | 31 | 33 | 64 |
| 2021 August | 56 | 23 | 79 |
| 2021 July | 26 | 17 | 43 |
| 2021 June | 18 | 18 | 36 |
| 2021 May | 33 | 26 | 59 |
| 2021 April | 29 | 53 | 82 |
| 2021 March | 59 | 20 | 79 |
| 2021 February | 29 | 8 | 37 |
| 2021 January | 23 | 20 | 43 |
| 2020 December | 24 | 12 | 36 |
| 2020 November | 36 | 17 | 53 |
| 2020 October | 44 | 15 | 59 |
| 2020 September | 56 | 34 | 90 |
| 2020 August | 56 | 24 | 80 |
| 2020 July | 87 | 20 | 107 |
| 2020 June | 73 | 30 | 103 |
| 2020 May | 62 | 20 | 82 |
| 2020 April | 75 | 26 | 101 |
| 2020 March | 65 | 17 | 82 |
| 2020 February | 54 | 63 | 117 |
| 2020 January | 49 | 21 | 70 |
| 2019 December | 56 | 16 | 72 |
| 2019 November | 69 | 17 | 86 |
| 2019 October | 66 | 16 | 82 |
| 2019 September | 65 | 28 | 93 |
| 2019 August | 113 | 25 | 138 |
| 2019 July | 123 | 17 | 140 |
| 2019 June | 132 | 26 | 158 |
| 2019 May | 146 | 43 | 189 |
| 2019 April | 115 | 37 | 152 |
| 2019 March | 215 | 20 | 235 |
| 2019 February | 172 | 19 | 191 |
| 2019 January | 168 | 16 | 184 |
| 2018 December | 85 | 10 | 95 |
| 2018 November | 52 | 2 | 54 |
| 2018 October | 66 | 6 | 72 |
| 2018 September | 39 | 9 | 48 |
| 2018 August | 46 | 27 | 73 |
| 2018 July | 51 | 33 | 84 |
| 2018 June | 64 | 18 | 82 |
| 2018 May | 80 | 24 | 104 |
| 2018 April | 112 | 33 | 145 |
| 2018 March | 104 | 26 | 130 |
| 2018 February | 68 | 15 | 83 |
| 2018 January | 92 | 15 | 107 |
| 2017 December | 79 | 12 | 91 |
| 2017 November | 38 | 17 | 55 |
| 2017 October | 16 | 14 | 30 |
| 2017 September | 35 | 18 | 53 |
| 2017 August | 26 | 21 | 47 |
| 2017 July | 28 | 10 | 38 |
| 2017 June | 30 | 21 | 51 |
| 2017 May | 40 | 12 | 52 |
| 2017 April | 17 | 4 | 21 |
| 2017 March | 15 | 67 | 82 |
| 2017 February | 15 | 5 | 20 |
| 2017 January | 15 | 4 | 19 |
| 2016 December | 12 | 6 | 18 |
| 2016 November | 6 | 5 | 11 |
| 2016 October | 13 | 4 | 17 |
| 2016 September | 4 | 8 | 12 |
| 2016 August | 2 | 0 | 2 |
| 2016 July | 5 | 3 | 8 |
| 2016 June | 4 | 0 | 4 |
| 2016 May | 3 | 16 | 19 |
| 2016 April | 1 | 10 | 11 |
| 2016 March | 3 | 11 | 14 |
| 2016 February | 3 | 14 | 17 |
| 2016 January | 10 | 4 | 14 |
| 2015 December | 7 | 4 | 11 |
| 2015 November | 3 | 2 | 5 |
| 2015 October | 3 | 2 | 5 |
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