Diagnosztikai nehézséget okozó pulmonalis infiltrátum

Translated title of the contribution: Diagnostic diffi culties caused by a pulmonary infi ltrate

Zsófia Simon, Ádám Jóna, Zsófia Miltényi, Edit Páyer, Attila Lieber, Mária Szilasi, Árpád Illés

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Lung infiltration still causes differential diagnostic difficulties, which may delay the start of definitive treatment. Case report: The examination of a 30-year-old man began due intermittent, remittent and permanent fever. Chest X-ray confirmed infiltration in the right upper lobe, which was accompanied by elevated CRP and physiological levels of procalcitonin. Most likely atypical pneumonia, tuberculosis, Wegener's granulomatosis or a malignant process was suspected. Throughout his examination infection could not be verified, repeated CT guided transthoracic needle biopsy suggested the possibility of a malignant process. Through surgical exploration the intraoperative histology was not informative; thus, the pneumonitis-remodelled right lung was removed due to the possibility of malignant transformation. Histological examination revealed lymphocyte rich classical Hodgkin lymphoma, which was found to be stage IV/B based on the 18FDG-PET/CT scan; therefore, eight cycles of ABVD (adriablastin, bleomycin, vinblastine, and dacarbazine) therapy was administered successfully. The patient is currently (for 30 months) in a complete metabolic remission. Conclusion: Primary pulmonary Hodgkin lymphoma is a rare disease entity (in this case it might be the original process), in which the diagnosis is often difficult. 18FDG-PET/CT may be a useful early diagnostic tool investigating fever of unknown origin.

Translated title of the contributionDiagnostic diffi culties caused by a pulmonary infi ltrate
Original languageHungarian
Pages (from-to)1077-1081
Number of pages5
JournalOrvosi hetilap
Volume153
Issue number27
DOIs
Publication statusPublished - Jul 1 2012

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Simon, Z., Jóna, Á., Miltényi, Z., Páyer, E., Lieber, A., Szilasi, M., & Illés, Á. (2012). Diagnosztikai nehézséget okozó pulmonalis infiltrátum. Orvosi hetilap, 153(27), 1077-1081. https://doi.org/10.1556/OH.2012.29404