Clinical Image
Endobronchial High-Grade Non-Hodgkin B-Cell Lymphoma Mimicking Small Cell Lung Cancer
a Division of Pulmonology, Ospedale Regionale di Bellinzona, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
b Institute of Pathology, Ospedale di Locarno, Ente Ospedaliero Cantonale (EOC), Locarno, Switzerland
c Division of Pulmonology, Department of Medicine, Lausanne University Hospital (CHUV), and University of Lausanne (UNIL), Lausanne, Switzerland
d Division of Pulmonology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), and Università della Svizzera Italiana (USI), Lugano, Switzerland
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(B) CT showed a micronodular lung pattern with cavitation consistent with the Cheerio sign (blue arrowheads). (C) Chest radiography showed improvement at 6 months after smoking cessation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alejandro García García, Jorge Mora Pinilla, Beatriz Raboso Moreno, María Teresa Río Ramírez, Araceli Abad Fernández" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Alejandro" "apellidos" => "García García" ] 1 => array:2 [ "nombre" => "Jorge" "apellidos" => "Mora Pinilla" ] 2 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Raboso Moreno" ] 3 => array:2 [ "nombre" => "María Teresa" "apellidos" => "Río Ramírez" ] 4 => array:2 [ "nombre" => "Araceli" "apellidos" => "Abad Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624000589?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000005/v1_202405030736/S0300289624000589/v1_202405030736/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289624000450" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.02.006" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "3486" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:304-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Delayed Presentation of Traumatic Diaphragmatic Rupture With Hemothorax" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "304" "paginaFinal" => "305" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 378 "Ancho" => 1200 "Tamanyo" => 80219 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracoabdominal sagittal (A), coronal (B), axial (C) CT; massive hemothorax (*) in the left pleural cavity, contour irregularity on the diaphragm surface and the appearance of diaphragm hematoma (H) are observed. Additionally, pancreas mass (black arrow) and adjacent spleen (S) metastasis (white arrow) are seen.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ayla Buyukkaya, Ramazan Buyukkaya" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Ayla" "apellidos" => "Buyukkaya" ] 1 => array:2 [ "nombre" => "Ramazan" "apellidos" => "Buyukkaya" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624000450?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000005/v1_202405030736/S0300289624000450/v1_202405030736/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Endobronchial High-Grade Non-Hodgkin B-Cell Lymphoma Mimicking Small Cell Lung Cancer" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "306" "paginaFinal" => "307" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luca Sardella, Elisabetta Merlo, Alessio Casutt" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Luca" "apellidos" => "Sardella" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Elisabetta" "apellidos" => "Merlo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "Alessio" "apellidos" => "Casutt" "email" => array:1 [ 0 => "alessio.casutt@chuv.ch" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Division of Pulmonology, Ospedale Regionale di Bellinzona, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Institute of Pathology, Ospedale di Locarno, Ente Ospedaliero Cantonale (EOC), Locarno, Switzerland" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Division of Pulmonology, Department of Medicine, Lausanne University Hospital (CHUV), and University of Lausanne (UNIL), Lausanne, Switzerland" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Division of Pulmonology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), and Università della Svizzera Italiana (USI), Lugano, Switzerland" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 640 "Ancho" => 1233 "Tamanyo" => 147372 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mass on axial view on pulmonary windowing (A, red arrow) and mediastinal enlarged lymph node stations (7 and 4R) on axial view on Positron Emission Tomography CT-scan showing a high avidity for fluorodeoxyglucose-F18 tracer (B, color). Endobronchial implants located at the distal <span class="elsevierStyleItalic">pars membranacea</span> of the trachea, main carina and main bronchi (C, blue arrows) treated by laser Argon-Beamer (D, blue arrows). Endobronchial samplings with solid growth neoplasm infiltrating the bronchial mucosa, made up of medium-sized cells, with moderately pleomorphic and hyperchromatic nuclei (E, hematoxylin–eosin staining 400×). Neoplastic cells express B-lineage marker CD20 (F). The diagnosis of B-cell lymphoma was also confirmed by molecular analysis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">High-grade pulmonary Non-Hodgkin B-cell lymphoma is rare and classics manifestations are systemic symptoms and post-obstructive pneumonia.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> Radiological findings typically describe a single pulmonary mass associated with mediastinal or hilar adenopathies and endobronchial involvement is unusual.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a> Tissues samples show a solid neoplastic tissue, consisting of medium to large sized cells with marked nuclear pleomorphism. Lymphomatous cells express B-lineage markers (CD20, CD19, PAX5). Small cell lung cancer is associated with tobacco consumption and usually presents as a hilar mass associated with bulky hilum and mediastinal lymph nodes involvement.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> Endobronchial involvement is rare. Neoplastic tissue shows a solid growth, small round/oval cells with high nuclear to cytoplasmic ratio. Neoplastic cells show a “dot-like” expression of cytokeratins and expression of neuroendocrine markers (Chromogranin-A, synaptophysin, CD56).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 82-years old former smoker patient was assessed for progressive asthenia and non-severe recurrent haemoptysis. The Computed Tomography-scan showed a right lower lobe sub-hilar mass (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1A</a>) associated with bulky mediastinal adenopathies (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1B</a>). The bronchoscopy documented the presence of well-vascularized endoluminal implants causing bleeding and treated by laser Argon-Beamer (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1C, D</a>). Both samplings guided by endobronchial ultrasound at lymph nodes stations 7/4R and endobronchial targeted biopsies were consistent with diffuse large B-cell lymphoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1E, F</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 640 "Ancho" => 1233 "Tamanyo" => 147372 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mass on axial view on pulmonary windowing (A, red arrow) and mediastinal enlarged lymph node stations (7 and 4R) on axial view on Positron Emission Tomography CT-scan showing a high avidity for fluorodeoxyglucose-F18 tracer (B, color). Endobronchial implants located at the distal <span class="elsevierStyleItalic">pars membranacea</span> of the trachea, main carina and main bronchi (C, blue arrows) treated by laser Argon-Beamer (D, blue arrows). Endobronchial samplings with solid growth neoplasm infiltrating the bronchial mucosa, made up of medium-sized cells, with moderately pleomorphic and hyperchromatic nuclei (E, hematoxylin–eosin staining 400×). Neoplastic cells express B-lineage marker CD20 (F). The diagnosis of B-cell lymphoma was also confirmed by molecular analysis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary pulmonary lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Cadranel" 1 => "M. Wislez" 2 => "M. Antoine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.02.00404102" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2002" "volumen" => "20" "paginaInicial" => "750" "paginaFinal" => "762" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12358356" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary pulmonary B-cell lympgoma: a review and update" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Sanguedolce" 1 => "M. Zanelli" 2 => "M. Zizzo" 3 => "A. Bisagni" 4 => "A. Soriano" 5 => "G. Cocco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/cancers13030415" "Revista" => array:5 [ "tituloSerie" => "Cancers" "fecha" => "2021" "volumen" => "13" "paginaInicial" => "415" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33499258" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endotracheal and endobronchial metastases of small cell lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Lu" 1 => "X. Zhu" 2 => "N. Shen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201708-1773IM" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2018" "volumen" => "197" "paginaInicial" => "1628" "paginaFinal" => "1629" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29490149" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000005/v1_202405030736/S0300289624000528/v1_202405030736/en/main.assets" "Apartado" => array:4 [ "identificador" => "94561" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000005/v1_202405030736/S0300289624000528/v1_202405030736/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624000528?idApp=UINPBA00003Z" ]
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