Abstract
A 76-year-old man was transferred to the ICU because of a suddenly worsened respiratory function. He noticed a skin tumor on his back a few weeks ago. Chest radiograph showed diffuse bilateral infiltration. Computed tomography demonstrated interstitial pneumonia-like findings and systemic lymph node swelling. Inguinal lymph node biopsy revealed that he suffered from non-Hodgkin lymphoma, which expressed both CD4(+) and CD56(+). Bronchoalveolar lavage (BAL) revealed that almost all cells were lymphoma cells, which also expressed both CD4(+) and CD56(+). Respiratory failure was managed according to the strategy toward acute respiratory distress syndrome. After chemotherapy, his respiratory function significantly improved. This case indicates that acute respiratory failure, which shows diffuse bilateral infiltration on chest radiograph, can be caused by the lung involvement of malignant lymphoma. BAL is useful for diagnosis, and chemotherapy would improve respiratory failure.
