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Open Access Case report

Solitary pulmonary mass in a patient with a history of lymphoma: a case report

Ying Yuan1, Hong Shen1, Hanguang Hu1, Xiaoxian Ye1 and Xian Zhong23*

Author Affiliations

1 Department of Medical Oncology, the Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China

2 Binjiang branch of the Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China

3 Hangzhou Binjiang Hospital, Hangzhou, China

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Journal of Medical Case Reports 2013, 7:113  doi:10.1186/1752-1947-7-113

Published: 25 April 2013



With the progress made in treatments, the survival rate for patients with malignant lymphoma in the last 30 years has significantly improved. However, the risk of experiencing a second primary malignancy or other disease has increased significantly.

Case presentation

A 44-year-old Mongolian man with a large mass in his right lower abdomen was admitted to our hospital 15 years previously. The mass was removed, and confirmed via pathological examination to be a malignant B-cell lymphoma in the appendix and distal small bowel. Post-operative chemotherapy with standard cyclophosphamide, hydroxydaunomycin, vincristine (OncovinĀ®) and prednisolone regimen was given for six cycles. No obvious recurrence was detected over the following 12 years. Subsequently, a mass in the right lung was found on a regular X-ray follow-up; our patient did not report chills, fever or cough. Chest computed tomography and positron emission tomography scans confirmed the mass. A primary lung carcinoma was considered to be the most likely diagnosis. However, after an exploratory thoracotomy and right upper lobectomy was performed a pathological examination of tissue samples demonstrated a lung cryptococcal granuloma, with positive staining for periodic acid Schiff and periodic acid-silver metheramine.


Compared to the normal population, second primary malignancy (in particular leukaemia and lung cancer) in patients with malignant lymphoma during their long-term survival has been seen occasionally. However, other diagnoses should also be considered such as pulmonary cryptococcosis. Other than computed-tomography-guided needle biopsy, surgery for some patients is a much more appropriate choice, which could also help attain correct diagnosis and treatment.