Key result
R-CHOP and LMWH achieve complete remission and thrombus improvement in pulmonary lymphomatoid granulomatosis.
Why the study?
Pulmonary lymphomatoid granulomatosis is a rare aggressive B cell lymphoproliferative disease with limited data on complications such as venous thromboembolism during treatment.
Case Report (n=1)
Highlights the successful management of venous thrombosis with LMWH in a patient undergoing chemo-immunotherapy for pulmonary lymphomatoid granulomatosis.
Supports LMWH with R-CHOP for pulmonary lymphomatoid granulomatosis with VTE; hypothesis-generating for this rare entity.
Lymphomatoid granulomatosis (LG) is Epstein-Barr virus associated and aggressive B cell lymphoproliferative disease. The most common sites of involvement are lungs, skin, kidneys, liver and central nervous system. The clinical presentation of pulmonary LG may mimic infectious diseases, malignancies or vasculitis. While treatment approach of low grade disease is watch and wait, patients with advanced stage require aggressive treatment with chemotherapy. Patients with hematological malignancy as well as solid tumors are at increased risk of venous thromboembolic events (VTE). We reported here in a case of pulmonary LG who was complicated with VTE during treatment with chemo-immunotherapy After 4 cycles of R-CHOP, she achieved complete remission for LG and was followed up without relapse for 2 years. She was anticoagulated with Low-Molecular-Weight Heparin (LMWH) during chemotherapy period, and the thrombus improved over the next several weeks. While on this paper written, patient completed her pregnancy successfully under anticoagulation prophylaxis.
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Maral et al. (2022) conducted a case report in Pulmonary lymphomatoid granulomatosis complicated with venous thrombosis (n=1). R-CHOP and Low-Molecular-Weight Heparin (LMWH) was evaluated on Complete remission and thrombus improvement. A female patient with pulmonary lymphomatoid granulomatosis complicated by venous thrombosis achieved complete remission after 4 cycles of R-CHOP and thrombus improvement with LMWH.
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