Rapid development of diffuse pulmonary infiltrates in histiocytic lymphoma

A 24-year-old man with documented histiocytic lymphoma developed a nodular interstitial infiltrate, as shown by chest roentgenograms during a 10-day period of observation. He also developed fever, chills, and purulent sputum. Open-lung biopsy revealed histiocytic lymphoma without evidence of infection. This case demonstrates that lymphoma can cause rapid development of infiltrates observable by roentgenography. Because the infiltrate could be neoplastic or infectious, empiric therapy without an exact diagnosis is not warranted.