Abstract
Richter's transformation (RT) refers to the development of aggressive lymphoma during the course of CLL. Clinically, patients with RT present with an aggressive disease course with rapidly enlarging lymph nodes, hepatosplenomegaly, and elevated serum lactate dehydrogenase levels. But rarely it presents with extra nodal organ involvement at the beginning.We are reporting this case as our patient presented with RT in the lung involvement diagnosed while research of cavitary lesion etiology.An 80-year-old female patient was accepted to our clinic with complaints of malaise, fatigue, loss of appetite, weight loss of 10 kg within the last three months, and cough, sputum production, fever, and deterioration in her state of consciousness within the last month. The patient had been followed up with the diagnosis of CLL for two years without any medication.On thorax CT, a cavitary lesion measuring 2.9X3.5X3.1 cm was detected in the superior segment of the right lower lobe, diffuse multiple nodular lesions were detected in both lungs, and multiple mediastinal and bilateral hilar lymphadenopathies, the largest measuring 1.5 cm in diameter, were detected. Diagnostic bronchoscopy was performed.In the pathological examination of the transbronchial biopsy from cavitary lesion wall revealed T cell rich, large B cell lymphoma.It should be kept in mind that cavitary nodular lesions in the lungs could be observed when RT develops in patients with CLL.
- Copyright ©ERS 2015