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Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation

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Pulmonary intravascular lymphoma.

Carolina A Souza¹, Kimmen Quan, Jean Seely

¹Department of Diagnostic, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada. carolina_althoff@yahoo.ca

Journal of Thoracic Imaging

|August 26, 2009

Summary

Intravascular lymphoma (IVL) is a rare B-cell malignancy. This case highlights primary pulmonary IVL in an HIV-positive individual, successfully treated with chemotherapy and rituximab, achieving long-term remission.

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Published on: February 2, 2014

Area of Science:

Hematology
Oncology
Pulmonology

Background:

Intravascular lymphoma (IVL) is a rare non-Hodgkin lymphoma characterized by malignant lymphoid cells confined to blood vessel lumens.
Clinical presentations are often nonspecific, stemming from vascular obstruction and tissue hypoxia, frequently affecting the skin and central nervous system.
Primary pulmonary involvement is exceptionally uncommon.

Observation:

A case of primary pulmonary IVL is presented in an HIV-positive male with constitutional symptoms.
High-resolution computed tomography revealed centrilobular nodules and ground-glass opacities.
Thoracoscopic biopsy confirmed malignant lymphocyte infiltration within pulmonary vasculature.

Findings:

Histopathology showed accumulation of CD20-positive malignant lymphocytes within alveolar capillaries, pulmonary veins, and peribronchial arterioles.
Immunohistochemistry confirmed the B-lymphocyte origin of the malignant cells.
The patient presented with nonspecific constitutional symptoms.

Implications:

This case underscores the rarity of primary pulmonary IVL and its potential presentation in HIV-positive individuals.
Prompt diagnosis and combined chemotherapy, including rituximab, led to significant clinical and radiological improvement.
Successful treatment resulted in long-term disease-free survival, suggesting efficacy of current therapeutic strategies.