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Diffuse Large B-Cell Lymphoma With Pulmonary and Gastric Involvement Mimicking Nontuberculous Mycobacterial Lung

Kosuke Masuda1, Kazuhiro Asada1, Yuu Saitoh2

  • 1Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan.

Respirology Case Reports
|May 4, 2026
PubMed

Insights

This case study describes a patient with pulmonary nodules initially suspected to be nontuberculous mycobacterial lung disease. Diagnosis was revised to diffuse large B-cell lymphoma (DLBCL) after atypical progression, highlighting the need for histological confirmation.

Area of Science:

  • Pulmonology
  • Oncology
  • Infectious Diseases

Background:

  • Pulmonary nodules can present diagnostic challenges.
  • Nontuberculous mycobacterial lung disease and lymphoma can mimic each other radiologically.

Purpose of the Study:

  • To present a case of pulmonary lymphoma mimicking mycobacterial infection.
  • To emphasize the importance of histological diagnosis in atypical presentations.

Main Methods:

  • Chest computed tomography (CT) for initial nodule detection.
  • Bronchoscopy for microbiological investigation.
  • Surgical lung biopsy for definitive diagnosis.
  • Systemic chemotherapy for treatment.

Main Results:

  • Initial CT revealed multiple bilateral pulmonary nodules.
  • Bronchoscopy identified *Mycobacterium intracellulare*.
  • Some nodules regressed, while others progressed despite antimicrobial therapy.
  • Surgical biopsy confirmed diffuse large B-cell lymphoma (DLBCL) with gastric involvement.
  • Complete remission was achieved with chemotherapy.

Conclusions:

  • Pulmonary lymphoma can present with heterogeneous radiological behavior, mimicking infectious diseases.
  • Atypical clinical courses necessitate prompt histological confirmation.
  • Multidisciplinary evaluation is crucial for accurate diagnosis and management.

Keywords:
Mycobacterium intracellularediffuse large B‐cell lymphomanontuberculous mycobacteriapulmonary nodulesradiological heterogeneity

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