A 62-year-old woman presented with abnormal chest radiographic findings without symptoms. Chest high-resolution computed tomography (HRCT) showed bilateral diffuse micronodules with a perilymphatic distribution and peribronchial thickening (Picture 1). Serum lactate dehydrogenase, ferritin and angiotensin-converting enzyme levels were within normal range, serum interleukin-2 receptor (1,470 U/mL) levels were mildly elevated. Bronchoalveolar lavage fluid and a transbronchial lung biopsy revealed no specific findings suggestive of a definite diagnosis. Suspecting sarcoidosis, a surgical lung biopsy was performed from S2, 6 and 9 of the right lung. A pathologic examination revealed multiple neoplastic follicles consisting of centrocytes (Picture 2), resulting in a diagnosis of follicular lymphoma. She received chemotherapy at the Department of Hematology.
Picture 1.
Picture 2.
The common pulmonary imaging features in non-Hodgkin's lymphoma are masses, small nodules and peribronchial thickening (1). To our knowledge, this is the first case of pulmonary follicular lymphoma showing diffuse micronodules with a perilymphatic distribution on HRCT. Even in asymptomatic patients, follicular lymphoma should be considered as a rare differential diagnosis.
The authors state that they have no Conflict of Interest (COI).
References
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