Bronchiolitis obliterans organizing pneumonia as an indicator of B-cell chronic leukemia malignancy progression - a case report.

We present a case of 65-year old gentlemen, diagnosed 8 months earlier with B-cell chronic lymphocytic leukemia, who presented symptoms of long lasting severe pneumonia with no significant reaction to antibiotics. Chest CT scan showed well-localized consolidation with ground glass opacities and some air bronchogram, suggesting bacterial or atypical etiology of infectious disease. All testing for infectious factors came back negative. Due to radiological progression of parenchymal consolidation despite two intravenous antibiotics open lung biopsy was performed. The histologic examination of lung specimen reveled structures typical for bronchiolitis obliterans organizing pneumonia. There was no evidence for leukemic involvement in lung tissue, as no sign for infectious factors from histological staining was observed. In the inferior mediastinal lymph node sample progression of chronic lymphatic leukemia to mixed cell lymphoma was diagnosed. Patient was commenced on prednisone 60 mg/daily. Fast improvement in his condition was noted. We believe that this is the first case of bronchiolitis obliterans organizing pneumonia as an indicator of B-cell chronic lymphocytic leukemia progression to more malignant stage. PMID: 25985790 [PubMed - as supplied by publisher]
Source: Pneumonologia i Alergologia Polska - Category: Respiratory Medicine Authors: Tags: Pneumonol Alergol Pol Source Type: research