CASE PRESENTATION: A 44-year-old man with a history of asthma presented with intermittent convulsion of the right limb, fever in the late afternoon, and decreased exercise tolerance over 2 months. Occasional productive cough, no hemoptysis, and weight loss of nearly 6 kg were observed during this period. Neither chemotherapy nor oral immunosuppressive drugs had been administered, and no exposure to toxic substances was known. He was a cook and had smoked approximately one pack of cigarettes per day for the past 20 years. The living environment was relatively humid. The patient presented to a local hospital, where the workup was notable for low-density shadows in the left parieto-occipital lobe and a cavity in the right upper lobe of the lung with bilateral diffuse interlobular septal thickening and multiple patchy ground-glass opacities. The brain and lung lesions were F-18-fluorodeoxyglucose avid on PET/CT scan. Bronchoscopy with BAL and transbronchial biopsy were nondiagnostic. While preparing for another diagnostic procedure, the patient gradually developed increasing dyspnea and more frequent convulsions with the progression of lesions on the follow-up chest CT scan. The patient was transferred to our hospital.

Primary pulmonary Hodgkin's lymphoma (PPHL) is an extremely rare disease. The nonspecific clinical and radiological features render the diagnosis a great challenge. Here, we present a case of PPHL mimicking rheumatoid arthritis-associated organizing pneumonia.

Anaplastic lymphoma kinase (ALK) negative anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin's lymphoma (NHL). Pulmonary infiltration with multiple nodules is an unusual manifestation. We present an adult patient who had diffuse lung and bone marrow involvement and review the pulmonary manifestation of ALCL. The present reports suggest that diffuse lung infiltration is associated with a bad clinical outcome.