Manifestation of severe pneumonia in anti-PL-7 antisynthetase syndrome and B cell lymphoma: A case report

Figure 1 Serial computed tomography scans of the chest. A: The computed tomography (CT) scan on July 7, 2019 showed bilateral ground-glass infiltrates in both upper lungs and lesions in the lingular segment of the left upper lobe and right middle lobe; B: The CT scan on July 13, 2019 showed irregular linear opacities and diffuse ground-glass opacities in both upper lungs and the bilateral pleural effusion. The lesions improved after meropenem plus moxifloxacin treatment; C: The CT scan on July 26, 2019 showed gradual bilateral consolidation in upper lobes and inferior lobes after imipenem-cilastatin plus caspofungin plus oral oseltamivir treatment; D: The CT scan on August 6, 2019 showed improvement in the bilateral consolidation after cefoperazone/sulbactam plus tigecycline treatment.

Figure 2 The manifestation of inflammatory myopathies in this patient. A: Rash on the patient’s face; B: Deltoid muscle biopsy showed irregular muscle fiber bundles, especially the abnormal lymphocyte infiltration (hematoxylin and eosin, 100 × magnification, black arrows).

Figure 3 Bone marrow biopsy revealed high invasive B cell lymphoma in the bone marrow. A: Bone marrow biopsy showed discordant bone marrow involvement with peritrabecular infiltrate of lymphoid cells (hematoxylin and eosin, 100 × magnification, black arrows); B: Lymphoma cells were seen in the bone marrow, positive for CD138 (CD138 immunohistochemistry, 100 magnification, black arrows).