TISSUE IS THE ISSUE: CASE OF PRIMARY PULMONARY PERIPHERAL T CELL LYMPHOMA

TOPIC: Lung Cancer TYPE: Medical Student/Resident Case Reports INTRODUCTION: Primary pulmonary lymphoma is a rare disease. It accounts for 0.5-1% of all malignancy and less than 1 % Non-Hodgkins Lymphoma (NHL) (1). Mostly they are B cell origin; however, there fourteen reported primary peripheral T Cell cases (2). We report case patient presenting with Lymphoma. CASE PRESENTATION: A 58-year-old woman presented complaints dyspnea, high-grade fever, cough the past 4-5 days. Physical exam was unremarkable except tachycardia, tachypnea, oxygen saturation 87% on room air. Laboratory workup elevated ESR, CRP, LDH, ferritin. Rheumatological unremarkable. Infectious workup, including COVID-19 PCR, blood cultures, respiratory viral panel, were Chest CT showed bilateral consolidation lungs hilar mediastinal lymphadenopathy (fig 1). She started broad-spectrum antibiotics admitted to medical floor. Her dyspnea got progressively worse, she intubated week after her admission. Bronchoscopy done bronchoalveolar lavage transbronchial biopsy; results Video-assisted thoracoscopic surgery ( VATS ) lymph node biopsy, biopsy came positive lymphoma(Fig 2, 3 ). Bone marrow The desaturate even maximal ventilator setting placed venovenous extracorporeal membrane oxygenation (V-V ECMO). given first cycle Gemcitabine oxaliplatin. However, developed multiorgan failure. transitioned comfort care expired. DISCUSSION: usually manifests symptoms cough, fever. mean age presentation fifty-three years. Radiographically it presents lung consolidation, atelectasis, pleural effusion, multiple nodular lesions. (3) Our had lymphadenopathy. Diagnosis made by lobectomy, open transthoracic needle biopsy. There still no recommended standard treatment due scarcity (4). Resection, radiotherapy, chemotherapy options used in patients suffering from this CONCLUSIONS: aggressive cancer. pneumonia-like symptoms. recommend clinicians consider bronchoscopy those pneumonia who do not get better antibiotics. REFERENCE #1: Cadranel J, Wislez M, Antoine M. lymphoma. Eur Respir J. 2002;20(3):750-762. doi:10.1183/09031936.02.00404102 #2: Zhang S, Liang B, Jiang S. T-cell lymphoma: review literature. Thorac Cancer. 2014;5(1):104-107. doi:10.1111/1759-7714.12042 #3: Sangho Lee, Bongkyung Shin, Hyungseok Yoon, Jung Yeon Gyu Rak Chon, NK/T as pneumonia, Respiratory Medicine Reports, Volume17,2016, Pages 1-4, ISSN 2213-0071, https://doi.org/10.1016/j.rmcr.2015.11.003. 4) Bernabeu Mora R, Sánchez Nieto JM, Olivares A. Bilateral nodules manifestation Int J Hematol. 2009;90(2):153-156. doi:10.1007/s12185-009-0372-8 DISCLOSURES: No relevant relationships Neil Amin, source=Web Response Olufunmilayo Folaranmi, Junaid mir, Salmaan Mumtaz, Ateeb Ur Rahman,