Abstract
A 69-year-old man sought medical care because of persistent cough. Imaging work up revealed multiple nodules involving both lungs. Fine needle aspiration biopsy (FNA) of the right lower lobe mass was performed and revealed atypical alveolar cells in a lymphoid background. The initial cytologic interpretation was "atypical alveolar cells, probably reactive." The patient underwent wedge resection of the right lower lobe. Intraoperative touch preparation revealed an atypical lymphoid proliferation. Histologic findings revealed multiple nodules of small and medium-sized lymphocytes replacing the lung parenchyma; lymphoepithelial lesions, and type II pneumocytes hyperplasia were also noted. Flow cytometry demonstrated the presence of a monoclonal B-cell population. A diagnosis of bronchial associated lymphoid tissue (BALT) lymphoma was established. The patient was treated with rituximab and was disease free 2 years after initial diagnosis.
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