Yüksek dereceli Non-Hodgkin lenfomalı hastada sistemik kemoterapi sonrası akciğer lezyonlarının ani düzelmesi

Lenfomalarda akciğer tutulumu primer ve sekonder olmak üzere iki şekilde görülmektedir. Lenfoma hücreleri, akciğerin değişik bölgelerini, yoğun biçimde infiltre edebilmektedir. 57 yaşında erkek hastanın 6 aydır devam eden göğüs ağrısı, boyunda şişlik, halsizlik, öksürük ve balgam yakınmaları mevcuttu. Hasta, hepatosplenomegali, son bir ayda kilo kaybı, ateş ve boynunun sol yanında büyüyen ağrılı şişlik nedeniyle kliniğimize yatırıldı. Fizik muayenede, boyunda ağrılı lenfadenopati saptandı. Solunum sistemi muayenesinde sağda solunum seslerinin şiddetinde azalma, yer yer krepitan raller mevcuttu. PA akciğer grafisinde sağ parahiler bölgede non homojen yaygın infiltrasyon saptandı. Toraks tomografisinde ise sağ akciğerde santralde hava bronkogramı izlenen konsolide alan, periferde nodüler ve retikülonodüler, sol akciğer alt lop posterobazal segmentte ve sol akciğer üst lop apikoposterior segmentte birkaç adet nodüler lezyon, paratrakeal lenf bezi ve lokalize alveoler diffüz infiltrasyonlar saptandı. Servikal lenf nodunu histolojik incelenmesinde yüksek grade büyük hücreli Non-Hodgkin lenfoma tanısı kondu. Hasta 6 siklus CEOP kürü aldı. Kemoterapi tamamlandıktan sonra yapılan inceleme- lerde daha önce varolan akciğer lezyonlarının tümünün kaybolduğu görüldü. Bu vaka sistemik non-Hodgkin lenfoma seyri sıra- sında akciğeri tutulumu gelişen ve tek başına kemoterapi ile uzun süreli remisyona giren bir nadir olgudur.

Sudden resolution of pulmonary lesions after systemic chemotherapy for high grade Non-Hodgkin lymhpoma

Pulmonary infiltrations of lymphomas presents as primary or secondary forms. The lymphoma cells infiltrate widely in the lung A 57-year old man admitted to our hospital with chest pain, nodal enlargement in neck, malaise, cough, and sputum. The patient was hospitalized due to the signs of hepato-splenomegaly, weight lost, fever, and growing mass in left neck. Physical examination revealed painful lymph node. In chest examination, there was low amplitude of pulmonary sounds in right basal area and occasional crepitan ralles. Hepatomegaly and splenomegaly were detected. The patient had parahilar non-homogenous diffuse infiltration in chest X-ray. The patient also had abnormal chest tomographic findings. The patient had diagnosis of high grade large cell non-Hodgkin lymphoma proven by histologically. The patient has been treated with 6 courses CEOP chemotherapy. The patient was in good condition without evidence of previously existing pulmonary lesions after completion of chemotherapy. This patient had sudden resolution of pulmonary lesions with long lasting remission after systemic chemotherapy for high grade large cell NonHodgkin lymhpoma involving the lung.

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