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Case Reports
. 2016 Dec;7(4):484-487.
doi: 10.1007/s13193-016-0525-1. Epub 2016 Apr 29.

Pulmonary Lymphomatoid Granulomatosis- a Case Report with Review of Literature

Grover Ankita  1 , Dhawan Shashi  1
Affiliations
Case Reports

Pulmonary Lymphomatoid Granulomatosis- a Case Report with Review of Literature

Grover Ankita et al. Indian J Surg Oncol. 2016 Dec.

Abstract

Lymphomatoid granulomatosis is a rare, Epstein Barr Virus (EBV)-associated systemic angiodestructive disorder that may progress to a diffuse large B cell lymphoma. Pulmonary involvement occurs in over 90 % cases followed by kidney, skin and brain. WHO classifies lymphomatoid granulomatosis under the generic heading of B cell proliferations of uncertain malignant potential. Radiologically, pulmonary lymphomatoid granulomatosis (PLG) presents with non specific findings making histopathology the gold standard for diagnosis. The histological diagnosis of PLG includes a triad of polymorphic lymphoid infiltrates, transmural infiltration of arteries and veins by lymphoid cells ("angiitis"), and focal areas of necrosis within the lymphoid infiltrates. PLG should be distinguished from granulomatosis with polyangitis, as well as other forms of malignant lymphoma, like extranodal NK/T cell lymphoma, secondary diffuse large B-cell lymphoma and primary Non Hodgkin lymphomas of lung.

Keywords: EBV; Grading; Immunohistochemistry; Lymphoproliferative disorder; Prognosis; Pulmonary involvement; Rare.

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Conflict of interest statement

Compliance with Ethical Standards Final Approval of Manuscript All authors. Disclosure of Conflict of Interest The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
a Photomicrograph showing angiodestructive and angioinvasive pattern of infiltrate. b areas of necrosis. c polymorphic infiltrate comprising mature lymphocytes, plasma cells, histiocytes and atypical large lymphoid cells. d Reed- Sternberg like cell is seen in the centre of the field
Fig. 2
Fig. 2
a Large atypical cells stain positive for EBV. b CD 20 positive in atypical large cells. c CD3 positive in background lymphocytes. d CD 68 positive in histiocytes. e CD 30 positve in atypical large cells. ALK1 and CD15 were negative
See this image and copyright information in PMC

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