Lymphomatoid granulomatosis in a 23-year-old man--cytological and histological typing and rapid response to steroid and cyclophosphamide combination therapy.

Lymphomatoid granulomatosis (LG) is currently called as extranodal angiocentric and angiodestructive immunoproliferative disorder with various degrees of histological differentiation and disease severity. Histological grading and clinical manifestations are due to number of atypical large EBV + B-lymphatic cells. We report the case of a 23-year-old man clinically presented with fever, sweating, and physical intolerance, and bilateral pulmonary infiltrates of nodular type and destructive changes on the chest X-ray, previously treated with antituberculotics for 1.5 month. As the disease showed progression, diagnostic procedures extended to transbronchial lung biopsy and percutaneous fine needle aspiration with cytological and histological analysis of collected specimens, all being not conclusive enough. LG was confirmed by open lung biopsy, followed by induction of corticosteroids and cyclophosphamide therapy. Very good clinical, functional and radiomorphologic improvement was achieved in a few weeks, and remission of disease maintained in long term follow-up.

[Paraneoplastic syndrome associated with antiphospholipid antibodies]. / Paraneoplasticki sindrom povezan s antifosfolipidnim protutijelima.

In patients with malignant tumour signs and symptoms develop that cannot be explained on the basis of the mass effect produced by either primary tumour or its metastases, production of a hormone associated with tissue type giving rise to the malignant tumour, or patients' immune status. These symptom complexes are known as paraneoplastic syndrome. It is known that the patients with malignant tumours are prone to develop venous thromboembolism in any stage of their disease. It is suggested that thromboembolic manifestations in cancer patients may be part of the secondary antiphospholipid syndrome (APS) and an example of the paraneoplastic autoimmunity, eg., paraneoplastic syndrome. Antiphospholipid antibodies (APA), e.g., anticardiolipin antibodies (ACA) and circulating lupus anticoagulant (LAC) are known to predispose to venous and arterial thromboses. The growing number of clinical reports on the association of APA and malignant tumours suggests that APA may be one of contributory factors in the paraneoplastic thromboembolism occurring in malignancy.