Correct!
2. CLL infiltration of the bronchi and lung
The biopsy shows a lymphocytic infiltrate of the bronchi consistent with CLL infiltration. No pathogens were identified and the special staining of the cells was consistent with CLL. Although lung cancer is possible in this patient, the histology and special staining is inconsistent with non-small cell cancer.
CLL infiltration is an infrequent cause of pulmonary symptoms (1,2). However, CLL infiltration is seen in about 40% of patients at autopsy, a frequency about double that seen in chronic myelogenous leukemia (3). Usually these infiltrates occur in the pulmonary parenchyma but airway involvement has been rarely reported (3).
Our patient’s treatment with ibrutinib was continued and her cough resolved. She continues to do well as an outpatient.
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