Correct!
2. B cell lymphoma

The patient’s disease process falls into the category of lymphoproliferative pulmonary disorders (LPDs). These disorders can be classified into reactive or non-neoplastic and malignant disorders (Table 1).


The reactive LPDs are associated with immunological disturbances and are commonly seen in patients with immunodeficiency or autoimmune disorders. Often these are associated with Epstein Barr virus infection especially in lymphomatoid granulomatosis or AIDS-associated lymphoma.

It is unclear what role azathioprine might have played in this patient’s disease process. Azathioprine has been associated with an increased risk of lymphoma but these usually have been associated with Epstein Barr virus infection and treatment for Crohn’s disease.

References

  1. Williams KE, Smith ML, Lyng PJ, Vaszar LT. October 2015 pulmonary case of the month: I've heard of Katy Perry. Southwest J Pulm Crit Care. 2015;11(4):126-35. [CrossRef]
  2. Hare SS, Souza CA, Bain G, et al. The radiological spectrum of pulmonary lymphoproliferative disease. Br J Radiol. 2012;85(1015):848-64. [CrossRef] [PubMed]
  3. Kotlyar DS, Lewis JD, Beaugerie L, et al. Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis. Clin Gastroenterol Hepatol. 2015 May;13(5):847-58. [CrossRef] [PubMed]

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