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Cavitary Pulmonary Lymphosarcoma Masquerading as Rheumatoid Lung Disease

Steven A. Sahn, MD; Thomas A. Neff, MD
JAMA. 1976;235(25):2751-2752. doi:10.1001/jama.1976.03260510045026.
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WE PRESENT the case of a woman with rheumatoid disease and bilateral infiltrates progressing to cavitary lung disease, subsequently diagnosed as lymphosarcoma of the lung. The purpose of this report is to remind the reader of this rare entity.

Report of a Case  A 46-year-old woman was first hospitalized at Denver General Hospital in April 1971, with a diagnosis of nonresolving bilateral pulmonary infiltrates (Fig 1). In April 1970, she had had the onset of morning stiffness, particularly in the fingers and wrists. These symptoms were progressive over the next year.On admission to the hospital, she had bilateral lower-lung-zone inspiratory rales and bronchovesicular breath sounds. Swelling, tenderness, and mild erythema of the proximal interphalangeal joints of both hands were present. The wrists and ankles showed evidence of mild synovitis. No subcutaneous nodules, lymphadenopathy, or splenomegaly were noted.Laboratory values were as follows: hematocrit, 35 vol%; white blood cells, 6,500/cu


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