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Images in Clinical Rheumatology
Diffuse Large B-cell Lymphoma of the Lung in a Patient With Nonspecific Interstitial Pneumonia
Linfoma difuso de células B grandes pulmonar en paciente con neumonía intersticial no específica
Luis Gorospe Sarasúaa,
Corresponding author
luisgorospe@yahoo.com

Corresponding author.
, Paola Arrietab, Anabelle Chinea-Rodríguezc, Carlos de la Puente-Bujidosd
a Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain
c Servicio de Hematología, Hospital Universitario Ramón y Cajal, Madrid, Spain
d Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Posteroanterior X-ray of the chest in which several nodular opacities are observed in the right lung &#40;arrow&#41;&#46; Note the presence of a subtle bibasal enlargement of the lung interstitium&#46; &#40;B&#41; Axial image of chest CT which confirms the presence of right lung masses &#40;asterisks&#41;&#46; &#40;C&#41; Axial image of chest CT &#40;minimum intensity projection&#41; in which a bibasal lung interstitium reticulation &#40;arrows&#41; may be observed in relation to the patient&#39;s interstitial lung disease&#46; Note the presence of small traction bronchiectasis&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 66 year-old patient who presented at surgery with dyspnoea&#46; A chest X-ray revealed multiple opacities in the right lung &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Of note in the patient&#39;s medical history was high blood pressure&#44; type 1 diabetes mellitus &#40;both controlled&#41;&#44; and nonspecific interstitial pneumonia &#40;NSIP&#41; which had been confirmed several years previously by means of a biopsy&#46; Computerised tomography &#40;CT&#41; of the chest confirmed the presence of multiple right lung masses &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#44; with aerial bronchogram&#44; with no pleural or lymph node effusion&#44; and with interstitial involvement &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a><span class="elsevierStyleSmallCaps">C</span>&#41;&#46; Transbronchial biopsy confirmed high grade diffuse large B-cell non-Hodgkin lymphoma &#40;DLBCL&#41;&#46; Positron emission tomography&#47;CT &#40;PET&#47;CT&#41; ruled out other tumours&#46; The patient was treated with chemotherapy &#40;R-CHOP regimen&#41;&#44; with complete response after 6 cycles&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Lung DLBCL is a rare subtype of primary lung lymphoma &#40;PLL&#41; which may be associated with states of immunosuppression &#40;infection by human immunodeficiency virus&#44; common variable immunodeficiency&#41;&#44; a tobacco habit and autoimmune diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> Of the latter&#44; Sj&#246;gren&#39;s syndrome and rheumatoid arthritis are the most common&#46; Our case is interesting since none of the described associations presented&#44; but NSIP did&#46; NSIP may be idiopathic or secondary &#40;among other causes&#41; to autoimmune diseases&#46; In order of frequency the following are of note&#58; systemic sclerosis&#44; polymiosytis&#47;dermatomyositis and mixed connective tissue disease&#46; Interstitial lung diseases which may be complicated with cancer are the usual interstitial penumonitis<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> &#40;bronchogenic carcinoma&#41; and lymphoid interstitial pneumonitis<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> &#40;PLL&#44; particularly in patients with Sj&#246;gren syndrome&#41;&#44; but no descriptions of lung DLBCL associated with an NSIP have been found&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that for this research no experimentation has been carried out on human beings or animals&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interests to declare&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Gorospe Saras&#250;a L&#44; Arrieta P&#44; Chinea-Rodr&#237;guez A&#44; de la Puente-Bujidos C&#46; Linfoma difuso de c&#233;lulas B grandes pulmonar en paciente con neumon&#237;a intersticial no espec&#237;fica&#46; Reumatol Clin&#46; 2019&#59;15&#58;e151&#8211;e152&#46;</p>"
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Article information
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