Abstract
A 76-year-old woman was referred to our hospital on September, 1993 for evaluation of dyspnea on exertion. Physical examination revealed diminished respiratory sounds in the left lung field and right inguinal lymphadenopathy. Chest X-ray showed atelectasis in the left lung. Computed tomography revealed atelectasis in the left lung and subcarinal lymphadenopathy. Emergency bronchoscopy showed an endobronchial fleshy friable lesion projecting from the left side of the trachea and occluding the left main bronchus totally. Pathologically the tumor was diagnosed as follicular and diffuse mixed cell type lymphoma. Specimens from the right inguinal lymph node showed the same pathological findings as from endobronchial one. The patient was diagnosed as stage IIIB according to the Ann Arbor classification. Chemotherapy was initiated with adriamycin, cyclophosphamide, vincristine, and prednisolone (CHOP), which resulted in resolution of her symptoms and roentogenographic abnormalities. After the fourth chemotherapy course, no tumor was found, and no malignant findings were observed in the specimen from left main bronchus. In its course, malignant lymphoma frequently involves intrathoracic structures. Although endobronchial involvement is not uncommon in Hodgkin's disease, it is rare in non-Hodgkin's lymphoma. We report a rare case of non-Hodgkin's lymphoma diagnosed by endobronchial involvement.
