BACKGROUND Patients with lymphoma are at risk for developing pulmonary opportunistic infections due to immunocompromise. However, clinical reports of concurrent lymphoma and opportunistic infection at presentation are rare and often confined to single cases. A delayed diagnosis of either opportunistic infection or lymphoma usually occurs in this complex situation. Here, we report such a case and analyse 18 similar cases searched in the PubMed database to deepen clinicians' understanding. CASE PRESENTATION A 48-year-old man presented with a 3-month history of fever, cough and emaciation. High-resolution computed tomography revealed bilateral cavitating lesions of different sizes. Aspergillus fumigatus complex was identified from a bronchoalveolar lavage fluid culture. However, antifungal treatment combined with multiple rounds of antibacterial therapy was unsuccessful, and the patient's lung lesions continued to deteriorate. Multiple puncture biopsies finally confirmed the coexistence of diffuse large B-cell lymphoma. Despite the initiation of combination chemotherapy, the patient died of progressive respiratory failure. CONCLUSIONS Synchronous pulmonary lymphoma and simultaneous opportunistic infection is rare and usually lacks specific clinical and imaging manifestations. Lymphoma should be considered as part of the differential diagnosis of patients with an opportunistic infection when treatment fails or other symptoms are present that could be considered "atypical" for the condition. Tissue biopsy is the gold standard, and multiple biopsies are essential for making the final diagnosis and should be performed upon early suspicion.

中文翻译：

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侵袭性肺曲霉病和弥漫性大B细胞淋巴瘤同时发生：病例报告和文献复习。

背景技术由于免疫功能低下，淋巴瘤患者有发展为肺机会性感染的风险。但是，并发淋巴瘤和机会性感染的临床报道很少，而且通常仅限于单个病例。在这种复杂情况下，通常会发生机会性感染或淋巴瘤的延迟诊断。在这里，我们报告了这种情况，并分析了在PubMed数据库中搜索的18个类似病例，以加深临床医生的理解。病例介绍一名48岁男性，有3个月的发烧，咳嗽和消瘦史。高分辨率计算机断层扫描显示不同大小的双侧空洞病变。从支气管肺泡灌洗液培养物中鉴定出烟曲霉。然而，抗真菌治疗结合多轮抗菌治疗均未成功，患者的肺部病变继续恶化。多次穿刺活检最终证实弥漫性大B细胞淋巴瘤并存。尽管开始联合化疗，患者仍死于进行性呼吸衰竭。结论同步性肺淋巴瘤和同时性机会感染很少见，通常缺乏特定的临床和影像学表现。当治疗失败或存在其他可能被视为“非典型”症状的症状时，应将淋巴瘤视为机会性感染患者鉴别诊断的一部分。组织活检是金标准，