1, female, 38 | Former smoker. Dry cough and light fever. No relevant auscultatory sounds. Suspect for lymphoproliferative disorder. | SaO2 99%. FVC 102% FEV1 99% DLCO 49% | Total cellularity: 630×106·L−1, N 0%, E 3.0%, L 77.0%, M 20.0% | Nodular opacities at superior lobe of right lung; multiple bilateral perilymphatic nodules, with ground-glass areas and thickening of septa. |
2, female, 41 | Nonsmoker; housewife; multiple sclerosis. Precedent diagnosis of T lymphoma-EBV-related, treated with a complete response. Light fever and dyspnoea. Presence of nodular skin lesions in lower limbs. | Lymphopenia (total lymphocytes: 0.42 109). FVC 100% FEV1 100% DLCO 52% | Total cellularity: 270×106·L−1, N 4.0%, E 0.0%, L 26.0%, M 70.0% | Bilateral lung opacities, predominantly perivascular, mostly at inferior lobes, with areas of consolidation. |
3, male, 68 | Respiratory insufficiency and pulmonary hypertension. Atrial fibrillation; dyslipidaemic; demyelinating polyneuropathy. Light fever, asthenia, confused state. Intravascular lymphoma? DAD? OP? other? | CRP 169; LDH 975. Monoclonal IgG λ component on protein electrophoresis. FVC 89% FEV1 91% DLCO 53% (mild restrictive deficit) | Total cellularity: 40×106·L−1, N 6.0%, E 0.0%, L 8.0%, M 86.0% | Diffuse density increasing and minimal consolidations in dorsal regions, mostly at inferior lobes. Suspect for DAD or OP. |
4, male, 57 | Nonsmoker; teacher; hypertension; MGUS since 2002, restricted for IgM κ. Tiredness, dyspnoea and light fever for 1 month. Splenomegaly. Suspect for intravascular lymphoma? HP? Other? | Pancytopenia; LDH 3194. Monoclonal IgG κ component on protein electrophoresis. Pulmonary hypertension: PAP 40 mmHg. Negative hypersensitivity specific antigens. FVC 107% FEV1 109% DLCO 42% | Total cellularity: 210×106·L−1, N 2.0%, E 0.0%, L 8.0%, M 90.0% | Ground glass with expiratory air trapping and mediastinal adenopathy. Suspect for intrinsic allergic alveolitis. |
5, female, 70 | Hashimoto thyroiditis and Sjögren syndrome. Light fever. MALT lymphoma? other? | No significant alterations. FVC 81% FEV1 81% DLCO 59% | Total cellularity: 210×106·L−1, N 3.0%, E 0.0%, L 30.0%, M 67.0% | Parenchymal bilateral consolidations, with thickening of interstitial septa (those nodules were also PET-positive). |
6, female, 63 | Former smoker; housewife; hypertension; MGUS. Fever, cough, arthralgias, light myopathy, Raynaud. Suspect for anti-synthetase syndrome. OP? NSIP? other? | Specific antibodies for polymyositis: ku ++, Ro-52 +++; high CPK and myoglobin. PaO2: 82.9 mmHg, PaCO2: 42.5 mmHg, pH: 7.39 U. Mild lymphopenia. Two monoclonal IgG components (one κ and one λ) on protein electrophoresis. FVC 105% FEV1 93% DLCO 55% | Total cellularity: 200×106·L−1, N 18%, E 1%, L 22%, M 5% | Interlobular reticular septal thickening and ground glass, honeycombing: suspect of fibrotic evolution of former interstitial pathologies. |
7, female, 31 | Nonsmoker; office worker. Former mononucleosis; asthma. Light fever, sweating, dry cough and pain at right shoulder. | CRP 60.9 mg· L−1; LDH 290. FVC 101% FEV1 91% DLCO 78% | Not available | Opacity at superior right lobe on CT scans and diffuse bone, lung, splenic and lymph nodes uptakes on PET. |
8, female, 74 | Nonsmoker; hypertension. Productive cough and light fever. | Monoclonal expression of IgG κ light chains on BAL. FVC 100% FEV1 85% DLCO 88% | Total cellularity: 510×106·L−1, N 33.0%, E 2.0%, L 55.0%, M 10.0% | Bilateral lung nodules, persistent after antibiotics therapy (with ground-glass areas and interstitial thickening). |
9, female, 78 | Previous diagnosis of diffuse large B-cell lymphoma and breast carcinoma. Lung nodules and mediastinal adenopathy. | Mild lymphopenia. LDH 316; CRP 67.3. Monoclonal IgG κ component on protein electrophoresis. FVC 101% FEV1 102% DLCO 76% | Total cellularity: 90×106·L−1, N 60.0%, E 0.0%, L 10.0%, M 30.0% | Lung opacities and mediastinal, abdominal and groin lymphadenopathy on CT-PET. |
10, male, 35 | Back pain some months earlier; worsening after antibiotics. Suspect for sarcoid versus MALT lymphoma. | Anaemia. LDH 112; CRP 73.4. FVC 100% FEV1 101% DLCO 73% | Total cellularity: 3720×106·L−1, N 6.0%, E 0.0%, L 94.0% | Hilar and para-hilar parenchymal opacities with mediastinal adenopathy. |
11, male, 40 | Nonsmoker; HIV+; positivity for Cryptococcus. Thoracic pain, cough and fever; enlargement of axillary lymph nodes. Suspect for lymphoma or cryptococcosis. | Anaemia. Peripheral blood: total CD3+ lymphocytes: 77%, with a CD4/CD8 ratio of 0.18. Functional pulmonary data not available | Total cellularity: 680×106·L−1, N 25.0%, E 0.0%, L 50.0%, M 25.0% | Multiple solid lung nodules, bilateral but predominant on the right. |
12, male, 60 | Former smoker; recent finding of lymphoplasmocytic lymphoma/Walderström on bone marrow biopsy. Weight loss and anaemia. Suspect for lymphomatous lesion versus fungi versus lung cancer. | Anaemia. FVC 103% FEV1 105% DLCO 88% | Total cellularity: 80×106·L−1, N 3.0%, E 0.0%, L 17.0%, M 80.0% | Bi-basal nodular areas, ground-glass areas, micronodular perilymphatic aspect, minimum pleuropericardic effusion. Splenomegaly. |
13, female, 45 | Nonsmoker. Went to ER for dry cough and thoracic pain; dyspnoea without fever. Suspect for lymphoma. | Anaemia. RCP 15. FVC 88% FEV1 95% DLCO 60% | Total cellularity: 330×106·L−1, N 3.0%, E 0.0%, L 35.0%, M 60.0% | Opacities with ground-glass halo, mediastinal and subdiaphragmatic adenopathy, splenomegaly with multiple hypodense lesions. |