Crazy paving pattern as a rare radiological manifestation of peripheral T-cell lymphoma (PTCL) with lung involvement: A case report

Georgia Gomatou; Vasilios Tzilas; Georgia Kourti; Styliani Lagou; Demosthenes Bouros; Konstantinos Syrigos

doi:10.1016/j.rmcr.2018.09.015

Crazy paving pattern as a rare radiological manifestation of peripheral T-cell lymphoma (PTCL) with lung involvement: A case report

Respir Med Case Rep. 2018 Sep 26:25:253-256. doi: 10.1016/j.rmcr.2018.09.015. eCollection 2018.

Authors

Georgia Gomatou¹, Vasilios Tzilas², Georgia Kourti¹, Styliani Lagou¹, Demosthenes Bouros², Konstantinos Syrigos¹

Affiliations

¹ 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
² First Academic Department of Pneumonology, Hospital for Diseases of the Chest, "Sotiria", Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

We report on a 70-year old woman with dyspnea, systemic lymphadenopathy and abnormal chest computed tomography (CT) findings. A complete laboratory testing as well as mediastinal tissue sampling via Endobronchial Ultrasound (EBUS)-guided Transbronchial Needle Biopsy (TBNB) did not reveal a definite diagnosis. After experiencing acute respiratory failure which led to intensive care unit, the patient underwent a cervical lymph node biopsy which revealed peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). A CT-guided trans-thoracic lung biopsy was performed that showed involvement of the lung parenchyma in the context of PTCL-NOS. Lung involvement is a rare extra-nodal manifestation of PTCL. The imaging patterns of this lymphoma have not been well described. We conclude that the finding of crazy paving pattern is a rare manifestation of this disease. In patients with pre-existing lymphoma, lung involvement should be included in the differential due to high pre-test probability.

Keywords: Crazy paving pattern; Lung lymphoma; Peripheral T-cell lymphoma.

Publication types

Case Reports