Abstract: Objective: To analyze the clinical features, imaging findings, diagnostic methods, pathomorphology and prognosis of the patients with primary pulmonary diffused large B-cell lymphoma (DLBCL) with the multiple ground glassy nodule shadows in the lungs as the main manifestation, and to improve the clinicians'understanding of the primary pulmonary DLBCL. Methods: The clinical data of a patient with primary pulmonary DLBCL were collected. The main manifestation in CT examination of the patient was multiple massive ground glass nodule shadows in the lungs. The initial diagnosis was pneumonia. The final diagnosis of primary pulmonary DLBCL was confirmed by pathology and immunohistochemistry examination. The related literatures were reviewed. Results: The female patient was admitted to hospital due to cough and expectoration as the first manifestations. There were no obvious positive signs in the physical examination. The CT examination results showed multiple ground glassy nodular shadows in both lungs.The tumor markers, lymph node color Doppler ultrasound, PET-CT, bone marrow biopsy, pathological biopsy and the other related examinations were performed, and the related treatment were given. The PET-CT results showed the multiple ground glass nodule in both lungs complicated with increasing of partial metabolism, and the pathological and immunohistochemical results suggested that the patient was non-Hodgkin DLBCL originated from the activated B cells outside the germinal center,and the final diagnosis was primary pulmonary DLBCL. The patient was given R-CHOP regimen regularly.The patient received chest CT examination 3 months later,and the results showed that the massive nodule shadows in both lungs were disappeared. Conclusion: The clinical features and imaging findings of the patient with primary pulmonary DLBCL are not specific, its diagnosis ultimately relies on the pathomophological and immunohistochemical examination results; the degree of malignancy of primary pulmonary DLBCL is high,and the prognosis is poor; when there are multiple ground glass nodule shadows in the lungs, the disease should be taken into account.

Key words: primary pulmonary lymphoma, diffused large B-cell lymphoma, pulmonary nodule, grinding glass nodule