[A case of lymphomatoid granulomatosis which initially demonstrated a diffuse ground glass appearance]

Lymphomatoid granulomatosis is defined as an Epstein-Barr virus-associated B-cell lymphoma which possibly progresses to malignant lymphoma. The pulmonary lesions associated with this disease typically reveal multiple poorly defined nodules. A 71-year-old man with acute respiratory failure consulted a local doctor. A chest CT scan demonstrated a bilateral lower ground glass appearance. The shadow improved after pulse steroid therapy but it showed multiple nodules after the corticosteroid treatment was tapered. We finally diagnosed lymphomatoid granulomatosis (grade 2) based on the findings of a thoracoscopic lung biopsy. Pathologically, an angiocentric proliferation of large atypical lymphoid cells were observed which were positive for EBER (EBV-encoded small RNA). We herein report the details of this case because of its rare radiographic findings.