case_images: PMC10730457_01
case_images: Clinical course and chest computed tomography images. (A) High-resolution computed tomography of the chest reveals a reticular shadow in the middle lobe of the right lung and axillary and mediastinal lymphadenopathy in 2015. (B) In 2021, worsened reticular opacity and consolidation are revealed in the middle lobe of the right lung. (C) After 2 months of treatment with prednisolone, the patient's symptoms and imagining findings improved. PSL, prednisolone; VATS, video-assisted thoracic surgery; WBC, white blood cell.
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case_images: High-resolution computed tomography (HRCT) of the chest revealed reticular opacities in the right middle lobe and right axillary and mediastinal lymphadenopathies (Figure 1A) and no hepatosplenomegaly. Her HRCT of the chest revealed worsening of the reticular opacities and new consolidations in the right middle lobe (Figure 1B). Prednisolone treatment was effective for her respiratory symptoms, chest image findings (Figure 1C), and peripheral blood neutrophil count (Figure 1).
case_images: Histopathological findings of the mediastinal lymph node. Haematoxylin-eosin stain reveals multiple lymphoid follicles with prominent germinal centres and a dense infiltrate of plasma cells in the interfollicular areas of the mediastinal lymph node. Immunoglobulin G4/G staining shows <10% staining.
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case_images: S4 showed lymphoid (not atypical lymphocyte)-dominant (Table 1), and however, lung biopsy specimens were pathologically nonspecific. She underwent in July 2021 pathological examination of surgical lung biopsy (partial excision of the right middle lobe and mediastinal hilar lymph node via video-assisted thoracic surgery) revealed plasma cells with multiple lymphoid follicles, with prominent germinal centres in the lymph node (Figure 2).