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Japanese Journal of Clinical Oncology 31:333-336 (2001)
© 2001 Foundation for Promotion of Cancer Research

Pulmonary Intravascular Lymphoma Complicated with Pneumocystis Carinii Pneumonia: a Case Report

Toshihide Kawamura1, Yoshichika Sando1, Syunji Tajima1, Tatsuya Hosono1, Mahito Sato1, Yuri Maeno1, Toshitaka Maeno1, Tatsuo Suga1, Masahiko Kurabayashi1 and Ryozo Nagai2,+,§

1Second Department of Internal Medicine, Gunma University, School of Medicine, Maebashi, Gunma and 2Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

We report a case of intravascular lymphoma (IVL) complicated with Pneumocystis carinii pneumonia (PCP). A 65-year-old male complaining of dyspnea and dementia was diagnosed to have pulmonary IVL by transbronchial lung biopsy. Concomitantly, deoxyribonucleic acid sequence specific to Pneumocystis carinii was detected in bronchoalveolar lavage fluid by polymerase chain reaction. Differential responses to the sequential treatments for PCP and IVL implied that increased serum lactate dehydrogenase (LDH) was due to PCP, whereas hypoxemia and dementia were due to IVL. Although pulmonary IVL and PCP share many clinical presentations, exact diagnosis is essential for their successful treatment.

+ For reprints and all correspondence: Yoshichika Sando, Second Department of Internal Medicine, Gunma University, School of Medicine, 3–39–22 Showa-machi, Maebashi 371-8511, Japan. E-mail: sandouy@showa.sb.gunma-u.ac.jp

§ Abbreviations: IVL, intravascular lymphoma; PCP, Pneumocystis carinii pneumonia; LDH, lactate dehydrogenase; FDG-PET, [18F]fluorodeoxyglucose positron emission tomography; CT, computed tomography; AST, aspartate aminotransferase; sIL-2R, soluble interleukin-2 receptor; BAL, bronchoalveolar lavage; DNA, deoxyribonucleic acid; AIVL, Asian variant of intravascular lymphomatosis; ST, sulfamethoxazole–trimethoprim


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