Adult T-cell leukemia/lymphoma presented with interstitial alveolar pattern of the lung: A case report

A 54-year-old man presented shortness of breath, cough, and a low-grade fever for days. Physical examination revealed mild splenomegaly and coarse crackles and rhonchi over bilateral lungs. No lymphadenopathy was found. A chest X-ray and a computed tomography scan showed diffuse alveolar and interstitial infiltration of the bilateral lung fields. Open lung biopsy revealed extensive, heavy infiltrates of atypical lymphoid cells within pulmonary parenchyma, in which the dilated vessels were completely filled with these atypical lymphocytes. Cytomegalovirus infection was also demonstrated histologically. Many floret lymphocytes were found in his peripheral blood smear. Primary adult T-cell leukemia/lymphoma of the lungs with secondary cytomegalovirus infection was diagnosed. We suggested adult T cell leukemia/lymphoma could be an entity of diagnosis in a patient presenting diffuse alveolar and interstitial infiltration of the lung images.