Email updates

Keep up to date with the latest news and content from Journal of Medical Case Reports and BioMed Central.

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

For all author emails, please log on.

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

Published: 25 April 2013

Abstract

Introduction

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 (Oncovin®) 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.

Conclusions

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.