array:24 [
  "pii" => "S1579212917304020"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2017.12.005"
  "estado" => "S300"
  "fechaPublicacion" => "2018-02-01"
  "aid" => "1689"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2018;54:108-9"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1953
    "formatos" => array:3 [
      "EPUB" => 147
      "HTML" => 1317
      "PDF" => 489
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289617302612"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2017.07.008"
      "estado" => "S300"
      "fechaPublicacion" => "2018-02-01"
      "aid" => "1689"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2018;54:108-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1769
        "formatos" => array:3 [
          "EPUB" => 119
          "HTML" => 1125
          "PDF" => 525
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
        "titulo" => "Granulomatosis linfomatoide&#58; una neoplasia infrecuente de mal pron&#243;stico"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "108"
            "paginaFinal" => "109"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Lymphomatoid Granulomatosis&#58; A Rare Tumor with Poor Prognosis"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1761
                "Ancho" => 2334
                "Tamanyo" => 592026
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Granulomatosis linfomatoide&#46; A&#41; N&#243;dulo pulmonar &#250;nico derecho y micron&#243;dulos en l&#243;bulo superior derecho y hemit&#243;rax izquierdo &#40;TAC de t&#243;rax&#41;&#46; B&#41; C&#233;lulas mononucleares de talla grande con el patr&#243;n angioc&#233;ntrico caracter&#237;stico y abundante necrosis tumoral &#40;H&#38;E&#44; &#215;10&#41;&#46; C&#41; Linfocitos de talla grande de estirpe B alrededor de vasos sangu&#237;neos &#40;CD20&#44; &#215;20&#41;&#46; D&#41; Positividad en las c&#233;lulas B grandes para la hibridaci&#243;n <span class="elsevierStyleItalic">in situ</span> del VEB &#40;EBER&#44; &#215;40&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "&#193;lvaro Guti&#233;rrez-Domingo, Ignacio Guti&#233;rrez-Domingo, Katherine Mar&#237;a Gallardo-Rodr&#237;guez"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "&#193;lvaro"
                "apellidos" => "Guti&#233;rrez-Domingo"
              ]
              1 => array:2 [
                "nombre" => "Ignacio"
                "apellidos" => "Guti&#233;rrez-Domingo"
              ]
              2 => array:2 [
                "nombre" => "Katherine Mar&#237;a"
                "apellidos" => "Gallardo-Rodr&#237;guez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212917304020"
          "doi" => "10.1016/j.arbr.2017.12.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917304020?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302612?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005400000002/v2_201802071714/S0300289617302612/v2_201802071714/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212918300211"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2017.06.010"
    "estado" => "S300"
    "fechaPublicacion" => "2018-02-01"
    "aid" => "1682"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2018;54:110-1"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1536
      "formatos" => array:3 [
        "EPUB" => 160
        "HTML" => 976
        "PDF" => 400
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Aspergilloma in Honeycomb Cysts and Paraseptal Emphysema&#58; An Unusual Association"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "110"
          "paginaFinal" => "111"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Aspergiloma en pulm&#243;n en panal y enfisema paraseptal&#58; una asociaci&#243;n poco habitual"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1050
              "Ancho" => 1500
              "Tamanyo" => 296908
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT images showing peripheral cysts pattern with honeycomb at the lung bases with an intracavitary nodule positioned anteriorly in the upper left lobe &#40;A&#41; that shifts position when the patient&#39;s decubitus is changed &#40;B&#41; &#40;arrows&#41;&#46; In C and D&#44; small intracavitary nodules are visible inside cysts in the right lung &#40;arrows&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Guilherme Felix Louza, Gl&#225;ucia Zanetti, Edson Marchiori"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Guilherme Felix"
              "apellidos" => "Louza"
            ]
            1 => array:2 [
              "nombre" => "Gl&#225;ucia"
              "apellidos" => "Zanetti"
            ]
            2 => array:2 [
              "nombre" => "Edson"
              "apellidos" => "Marchiori"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0300289617302545"
        "doi" => "10.1016/j.arbres.2017.06.027"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302545?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918300211?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005400000002/v2_201802071702/S1579212918300211/v2_201802071702/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212917304032"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2017.12.006"
    "estado" => "S300"
    "fechaPublicacion" => "2018-02-01"
    "aid" => "1690"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2018;54:107-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1276
      "formatos" => array:3 [
        "EPUB" => 143
        "HTML" => 746
        "PDF" => 387
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Reliability of the Minimum Basic Data Set as an Epidemiological Tool in Tuberculosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "107"
          "paginaFinal" => "108"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Fiabilidad del conjunto m&#237;nimo b&#225;sico de datos como herramienta epidemiol&#243;gica de la enfermedad tuberculosa"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Susana Garc&#237;a-de Cruz, Carmen Aldea-Mansilla, &#193;ngel Campos Bueno, Valent&#237;n del Villar Sordo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Susana"
              "apellidos" => "Garc&#237;a-de Cruz"
            ]
            1 => array:2 [
              "nombre" => "Carmen"
              "apellidos" => "Aldea-Mansilla"
            ]
            2 => array:2 [
              "nombre" => "&#193;ngel"
              "apellidos" => "Campos Bueno"
            ]
            3 => array:2 [
              "nombre" => "Valent&#237;n"
              "apellidos" => "del Villar Sordo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289617302624"
        "doi" => "10.1016/j.arbres.2017.07.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302624?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917304032?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005400000002/v2_201802071702/S1579212917304032/v2_201802071702/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Lymphomatoid Granulomatosis&#58; A Rare Tumor with Poor Prognosis"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "108"
        "paginaFinal" => "109"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "&#193;lvaro Guti&#233;rrez-Domingo, Ignacio Guti&#233;rrez-Domingo, Katherine Mar&#237;a Gallardo-Rodr&#237;guez"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "&#193;lvaro"
            "apellidos" => "Guti&#233;rrez-Domingo"
            "email" => array:1 [
              0 => "agutierrezdomingo&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ignacio"
            "apellidos" => "Guti&#233;rrez-Domingo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Katherine Mar&#237;a"
            "apellidos" => "Gallardo-Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Hospital Universitario Virgen Macarena&#44; Sevilla&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Medicina Interna&#44; Hospital San Juan de Dios&#44; Bormujos&#44; Sevilla&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Hospital Universitario Nuestra Se&#241;ora de Candelaria&#44; Santa Cruz de Tenerife&#44; Tenerife&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Granulomatosis linfomatoide&#58; una neoplasia infrecuente de mal pron&#243;stico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1761
            "Ancho" => 2334
            "Tamanyo" => 613571
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lymphomatoid granulomatosis&#46; &#40;A&#41; Right single pulmonary nodule and micronodules in the right upper lobe and left hemithorax &#40;chest CT&#41;&#46; &#40;B&#41; Large mononuclear cells with the typical angiocentric pattern and abundant tumor necrosis &#40;H&#38;E&#44; &#215;10&#41;&#46; &#40;C&#41; Large B cell lymphocytes surrounding the blood vessels &#40;CD20&#44; &#215;20&#41;&#46; &#40;D&#41; Large B cells positive for in situ hybridization of EBV &#40;EBER&#44; &#215;40&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of an asymptomatic 72-year-old woman with no significant clinical history&#44; in whom a lung mass with smooth outlines measuring 5&#46;1&#215;4<span class="elsevierStyleHsp" style=""></span>cm was observed in the right lower lobe during a routine CT&#46; Micronodules were also found in the right upper lobe and left hemithorax &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; PET showed pathological tracer uptake in the right lower lobe &#40;SUV maximum&#58; 34&#46;36&#41;&#44; suggestive of malignancy&#46; Functional tests showed moderate restriction&#46; After 2 nondiagnostic cytology specimens were obtained&#44; a diagnostic right lower lobectomy was performed&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The macroscopic examination revealed a firm&#44; nodular&#44; whitish mass measuring 5&#46;2<span class="elsevierStyleHsp" style=""></span>cm in its longest diameter&#46; Microscopic study found a multinodular tumor with areas of necrosis&#44; consisting of a heterogeneous lymphoid population of atypical large B cells &#40;CD20 positive&#41;&#44; with more than 20 cells per high-power field&#44; with an accompanying background of small T lymphocytes &#40;CD3 positive&#41;&#46; The neoplasm presented an angiocentric&#44; angiodestructive pattern&#46; In situ hybridization for the Epstein&#8211;Barr virus &#40;EBV&#41; was positive &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; These histological and immunohistochemical findings supported the diagnosis of lymphomatoid granulomatosis grade 3&#46; The patient received an initial cycle of immunochemotherapy&#44; but died 4 months after diagnosis&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Lymphomatoid granulomatosis&#44; first described in 1972 by Liebow et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> is a very rare type of extranodal lymphoma with a highly characteristic angiocentric&#44; angiodestructive pattern&#46; It typically affects more men than women &#40;2&#58;1&#41;&#44; particularly in the 3rd&#8211;5th decade of life&#44; and is more common in Western countries&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Clinically&#44; it normally involves both lungs&#46; Cough&#44; dyspnea&#44; and chest pain are the most typical symptoms&#44; and may be accompanied by fever&#44; weight loss&#44; etc&#46; Renal and skin involvement may occur&#44; and central nervous system involvement&#44; seen in up to 53&#37; of cases&#44; is noteworthy&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The most characteristic radiological sign is pulmonary nodules that affect the middle and lower lobes&#46; Other signs include central necrosis and&#47;or cavitation&#44; air bronchogram&#44; and a ground glass appearance&#46; It is occasionally diagnosed incidentally&#44; so this lymphoproliferative process should always be borne in mind during the diagnostic process&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Histologically&#44; this is a diffuse large B cell lymphoma associated with EBV&#44; which shows predilection for the blood vessels &#40;angiocentricity&#41;&#46; It is included in the new 2016 WHO lymphoma classification under the category of diffuse large B cell lymphoma &#40;DLBCL&#41; not otherwise specified &#40;NOS&#41; associated with EBV&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In high-grade cases&#44; it is considered an aggressive high-grade lymphoma&#44; so patients require immediate&#44; intensive treatment with immunochemotherapy regimens that include rituximab&#46; In the most aggressive cases&#44; mean survival is approximately 18 months&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In summary&#44; our patient presented lymphomatoid granulomatosis&#44; a very unusual type of extranodal lymphoma&#44; that mainly affects the lung&#44; and which presents very distinctive pathological characteristics&#46; Lymphomatoid granulomatosis must be taken into consideration in the differential diagnosis of other processes with similar radiological features&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Guti&#233;rrez-Domingo &#193;&#44; Guti&#233;rrez-Domingo I&#44; Gallardo-Rodr&#237;guez KM&#46; Granulomatosis linfomatoide&#58; una neoplasia infrecuente de mal pron&#243;stico&#46; Arch Bronconeumol&#46; 2018&#59;54&#58;108&#8211;109&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1761
            "Ancho" => 2334
            "Tamanyo" => 613571
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lymphomatoid granulomatosis&#46; &#40;A&#41; Right single pulmonary nodule and micronodules in the right upper lobe and left hemithorax &#40;chest CT&#41;&#46; &#40;B&#41; Large mononuclear cells with the typical angiocentric pattern and abundant tumor necrosis &#40;H&#38;E&#44; &#215;10&#41;&#46; &#40;C&#41; Large B cell lymphocytes surrounding the blood vessels &#40;CD20&#44; &#215;20&#41;&#46; &#40;D&#41; Large B cells positive for in situ hybridization of EBV &#40;EBER&#44; &#215;40&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lymphomatoid granulomatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;A&#46; Liebow"
                            1 => "C&#46;R&#46; Carrington"
                            2 => "P&#46;J&#46; Friedman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hum Pathol"
                        "fecha" => "1972"
                        "volumen" => "3"
                        "paginaInicial" => "457"
                        "paginaFinal" => "558"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4638966"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary large cell lymphoma of the mediastinum&#46; A histologic and immunophenotypic study of 29 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Lamarre"
                            1 => "J&#46;O&#46; Jacobson"
                            2 => "A&#46;C&#46; Aisenberg"
                            3 => "N&#46;L&#46; Harris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg Pathol"
                        "fecha" => "1989"
                        "volumen" => "13"
                        "paginaInicial" => "730"
                        "paginaFinal" => "739"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2788371"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lymphomatoid granulomatosis&#46; Prospective clinical and therapeutic experience over 10 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;S&#46; Fauci"
                            1 => "B&#46;F&#46; Haynes"
                            2 => "J&#46; Costa"
                            3 => "P&#46; Katz"
                            4 => "S&#46;M&#46; Wolff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM198201143060203"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1982"
                        "volumen" => "306"
                        "paginaInicial" => "68"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7053488"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "World Health Organization Classification of Tumours&#46; Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;S&#46; Jaffe"
                            1 => "N&#46;L&#46; Harris"
                            2 => "H&#46; Stein"
                            3 => "J&#46;W&#46; Vardiman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "1st ed&#46;"
                        "fecha" => "2001"
                        "editorial" => "IARC Press"
                        "editorialLocalizacion" => "Lyon"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The 2016 revision of the World Health Organization classification of lymphoid neoplasms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Swerdlow"
                            1 => "E&#46; Campo"
                            2 => "S&#46; Pileri"
                            3 => "N&#46; Harris"
                            4 => "H&#46; Stein"
                            5 => "R&#46; Siebert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1182/blood-2016-01-643569"
                      "Revista" => array:6 [
                        "tituloSerie" => "Blood"
                        "fecha" => "2016"
                        "volumen" => "127"
                        "paginaInicial" => "2375"
                        "paginaFinal" => "2390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26980727"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005400000002/v2_201802071702/S1579212917304020/v2_201802071702/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49861"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Scientific letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005400000002/v2_201802071702/S1579212917304020/v2_201802071702/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917304020?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 54. Issue 2.
Pages 108-109 (February 2018)
Vol. 54. Issue 2.
Pages 108-109 (February 2018)
Scientific Letter
Full text access
Lymphomatoid Granulomatosis: A Rare Tumor with Poor Prognosis
Granulomatosis linfomatoide: una neoplasia infrecuente de mal pronóstico
Visits
7970
Álvaro Gutiérrez-Domingoa,
Corresponding author
agutierrezdomingo@gmail.com

Corresponding author.
, Ignacio Gutiérrez-Domingob, Katherine María Gallardo-Rodríguezc
a Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, Spain
b Servicio de Medicina Interna, Hospital San Juan de Dios, Bormujos, Sevilla, Spain
c Servicio de Anatomía Patológica, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, Spain
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text
Dear Editor,

We report the case of an asymptomatic 72-year-old woman with no significant clinical history, in whom a lung mass with smooth outlines measuring 5.1×4cm was observed in the right lower lobe during a routine CT. Micronodules were also found in the right upper lobe and left hemithorax (Fig. 1). PET showed pathological tracer uptake in the right lower lobe (SUV maximum: 34.36), suggestive of malignancy. Functional tests showed moderate restriction. After 2 nondiagnostic cytology specimens were obtained, a diagnostic right lower lobectomy was performed.

Fig. 1.

Lymphomatoid granulomatosis. (A) Right single pulmonary nodule and micronodules in the right upper lobe and left hemithorax (chest CT). (B) Large mononuclear cells with the typical angiocentric pattern and abundant tumor necrosis (H&E, ×10). (C) Large B cell lymphocytes surrounding the blood vessels (CD20, ×20). (D) Large B cells positive for in situ hybridization of EBV (EBER, ×40).

(0.59MB).

The macroscopic examination revealed a firm, nodular, whitish mass measuring 5.2cm in its longest diameter. Microscopic study found a multinodular tumor with areas of necrosis, consisting of a heterogeneous lymphoid population of atypical large B cells (CD20 positive), with more than 20 cells per high-power field, with an accompanying background of small T lymphocytes (CD3 positive). The neoplasm presented an angiocentric, angiodestructive pattern. In situ hybridization for the Epstein–Barr virus (EBV) was positive (Fig. 1). These histological and immunohistochemical findings supported the diagnosis of lymphomatoid granulomatosis grade 3. The patient received an initial cycle of immunochemotherapy, but died 4 months after diagnosis.

Lymphomatoid granulomatosis, first described in 1972 by Liebow et al.1 is a very rare type of extranodal lymphoma with a highly characteristic angiocentric, angiodestructive pattern. It typically affects more men than women (2:1), particularly in the 3rd–5th decade of life, and is more common in Western countries.2

Clinically, it normally involves both lungs. Cough, dyspnea, and chest pain are the most typical symptoms, and may be accompanied by fever, weight loss, etc. Renal and skin involvement may occur, and central nervous system involvement, seen in up to 53% of cases, is noteworthy.3

The most characteristic radiological sign is pulmonary nodules that affect the middle and lower lobes. Other signs include central necrosis and/or cavitation, air bronchogram, and a ground glass appearance. It is occasionally diagnosed incidentally, so this lymphoproliferative process should always be borne in mind during the diagnostic process.4

Histologically, this is a diffuse large B cell lymphoma associated with EBV, which shows predilection for the blood vessels (angiocentricity). It is included in the new 2016 WHO lymphoma classification under the category of diffuse large B cell lymphoma (DLBCL) not otherwise specified (NOS) associated with EBV.5

In high-grade cases, it is considered an aggressive high-grade lymphoma, so patients require immediate, intensive treatment with immunochemotherapy regimens that include rituximab. In the most aggressive cases, mean survival is approximately 18 months.

In summary, our patient presented lymphomatoid granulomatosis, a very unusual type of extranodal lymphoma, that mainly affects the lung, and which presents very distinctive pathological characteristics. Lymphomatoid granulomatosis must be taken into consideration in the differential diagnosis of other processes with similar radiological features.

References
[1]
A.A. Liebow, C.R. Carrington, P.J. Friedman.
Lymphomatoid granulomatosis.
Hum Pathol, 3 (1972), pp. 457-558
[2]
L. Lamarre, J.O. Jacobson, A.C. Aisenberg, N.L. Harris.
Primary large cell lymphoma of the mediastinum. A histologic and immunophenotypic study of 29 cases.
Am J Surg Pathol, 13 (1989), pp. 730-739
[3]
A.S. Fauci, B.F. Haynes, J. Costa, P. Katz, S.M. Wolff.
Lymphomatoid granulomatosis. Prospective clinical and therapeutic experience over 10 years.
N Engl J Med, 306 (1982), pp. 68-74
[4]
E.S. Jaffe, N.L. Harris, H. Stein, J.W. Vardiman.
World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues.
1st ed., IARC Press, (2001),
[5]
S. Swerdlow, E. Campo, S. Pileri, N. Harris, H. Stein, R. Siebert, et al.
The 2016 revision of the World Health Organization classification of lymphoid neoplasms.
Blood, 127 (2016), pp. 2375-2390

Please cite this article as: Gutiérrez-Domingo Á, Gutiérrez-Domingo I, Gallardo-Rodríguez KM. Granulomatosis linfomatoide: una neoplasia infrecuente de mal pronóstico. Arch Bronconeumol. 2018;54:108–109.

Copyright © 2017. SEPAR
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?