Organizing pneumonia associated with T-cell lymphoma

Area of Science:

• Pulmonology
• Gastroenterology
• Oncology

Background:

• Coeliac disease (CD) is an autoimmune disorder.
• Refractory CD type II can progress to enteropathy-associated T-cell lymphoma (EATL).
• Organizing pneumonia (OP) is a lung condition with various potential causes.

Observation:

• A 61-year-old male with CD developed OP, refractory CD type II, and haemophagocytic lymphohistiocytosis.
• The patient was subsequently diagnosed with EATL nine months after the initial OP diagnosis.
• Multiple biopsies confirmed OP and later EATL, with no prior anticancer treatment.

Findings:

• This is the first reported case of OP associated with EATL.
• OP can occur in lymphoma patients without prior chemotherapy or bone marrow transplant.
• The underlying mechanism linking OP and EATL remains unclear.

Implications:

• OP may represent a T-cell dysfunction or a direct reaction to malignant lung infiltration in EATL.
• Surgical lung biopsy is crucial for excluding alternative diagnoses in atypical presentations.
• This case expands the understanding of potential pulmonary manifestations of EATL.