Intravascular pulmonary lymphoma with good response to treatment. A case report
Linfoma intravascular do pulmão: A propósito de um caso clínico com boa resposta à terapêutica
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
Correspondence to/Correspondência: Hospital de Santa Maria CHNL, EPE, Avenida Prof. Egas Moniz, Lisboa, Portugal.
Correspondence to/Correspondência: 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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Guest assistant professor Lisbon University School of Medicine" "etiqueta" => "<span class="elsevierStyleSup">7</span>" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Director do Serviço de Pneumologia. 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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>°C, pulse 100/min and respiratory 22 cycles/min.</p><p id="spar0015" 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 (FiO2 1l/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="spar0020" 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>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O linfoma intravascular é uma forma muito rara de linfoma não Hodgkin de células grandes B. Caracteriza-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, ema-grecimento não quantificado e dispneia progressiva. Ao exame objectivo apresentava-se febril, taquicárdica e polipneica. Analiticamente, destacava-se anemia, leucocitose e LDH elevada. Gasometria arterial - FiO2 1 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>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bilbiografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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