Successful application of extracorporeal membrane oxygenation treatment in the management of severe respiratory failure caused by primary pulmonary lymphoma A case report

Rationale: Primary pulmonary lymphoma (PPL) is a rare disease, and rapid progression of pulmonary exudation leads to severe respiratory failure. Here, we present the case of a critically ill patient with PPL complicated by refractory hypoxemic respiratory failure. The patient was ultimately cured with a successful combination of extracorporeal membrane oxygenation (ECMO) and chemotherapy. Patient concerns: A 36-year-old woman was hospitalized because of a 2-month history of cough with fever and shortness of breath. Computed tomography revealed multiple pulmonary nodules, consolidation, and solid pulmonary opacities. Complications of pneumothorax occurred after computed tomography-guided core needle biopsy, and respiratory failure progressively developed (PaO2/FiO(2) 65 mm Hg). Diagnosis: Primary pulmonary lymphoma, respiratory failure, stress cardiomyopathy, cardiogenic shock. Interventions: The patient was treated with veno-venous ECMO and chemotherapy. Outcomes: The patient was successfully weaned off ECMO after chemotherapy and transferred out of the intensive care unit on day 9. After regular chemotherapy, no obvious lesions were observed in either lung tissue. Conclusion: ECMO can be selected as an important salvage treatment for patients with severe cardiopulmonary dysfunction caused by PPL and other malignant tumors that may be cured or transferred to a stable stage.