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Yang L, Qu R, Liu F, Hu C. Pulmonary mucosa-associated lymphoid tissue lymphoma with Sjögren's syndrome and literature review: A case report. Medicine (Baltimore) 2023; 102:e35232. [PMID: 37713822 PMCID: PMC10508431 DOI: 10.1097/md.0000000000035232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/24/2023] [Indexed: 09/17/2023] Open
Abstract
INTRODUCTION A 54-year-old woman was admitted to hospital with chest tightness, shortness of breath, and chest pain on exertion. Her chest computed tomography showed a space-occupying lesion in the right lower lobe of the lung. CASE PRESENTATION The ultrasound-guided right lung mass biopsy showed mucosa-associated lymphoid tissue (MALT), and the patient was diagnosed with Sjögren's syndrome (SS). The patient's symptoms were partially relieved with chemotherapy. CONCLUSIONS Autoimmune diseases like SS and systemic lupus erythematosus are recognized risk factors for pulmonary MALT. It is necessary to identify predictors of malignant transformation of SS to pulmonary MALT lymphoma.
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Affiliation(s)
- Limin Yang
- Department of Hematology and Oncology, Second Hospital of Jilin University
| | - Rongfeng Qu
- Department of Hematology and Oncology, Second Hospital of Jilin University
| | - Fang Liu
- Department of Hematology and Oncology, Second Hospital of Jilin University
| | - Chunmei Hu
- Department of Hematology and Oncology, Second Hospital of Jilin University
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Yang B, Lee H, Lee T, Kim SH, Kim MY, Jeong BH, Shin S, Kim S, Lee KS, Kwon OJ, Kim H. The use of surgery in a real-world clinic to diagnose and treat pulmonary cryptococcosis in immunocompetent patients. J Thorac Dis 2019; 11:1251-1260. [PMID: 31179067 DOI: 10.21037/jtd.2019.04.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background We evaluated the role played by surgery in the diagnosis and treatment of pulmonary cryptococcosis (PC) in immunocompetent subjects. Methods We retrospectively studied 53 immunocompetent patients who were pathologically diagnosed with PC between January 2000 and December 2016 in a tertiary referral center. We compared the radiological presentations of, and diagnostic modalities used to evaluate, patients diagnosed both surgically and non-surgically. We also compared the treatment outcomes of patients who underwent surgical resection alone and those who received additional antifungals following surgical resection. Results Of the 53 patients, 30 (57%) were diagnosed via non-surgical modalities including percutaneous needle biopsy (PCNB) (n=29) and transbronchial lung biopsy (TBLB) (n=1); and 23 (43%) were diagnosed by surgical modalities including video-assisted thoracoscopic wedge resection (n=22) and lobectomy (n=1). An initial clinical suspicion of a lung malignancy was associated with the use of surgical diagnostic approaches (P<0.001). Whereas undetermined locations were associated with the use of surgical diagnostic approaches, radiological findings such as clustered nodular patterns (P<0.001), cavities (P=0.005), air bronchograms (P<0.001), and peripheral lesions (P<0.001) were associated with the use of non-surgical diagnostic approaches. Of the 30 non-surgically diagnosed patients, 21 (70%) were treated with antifungals and 9 (30%) were followed-up without treatment. Of the 23 patients who underwent surgical treatment, 8 received additional antifungals. The proportion of patients who had radiological improvement was significantly higher in surgically diagnosed patients than non-surgically diagnosed patients (100% vs. 73%; P=0.007). However, there was no significant difference in disease progression between patients who underwent surgical resection alone and those who additionally received antifungals (P=0.999). Conclusions Surgical resection was required in some patients to diagnose PC. An initial suspicion of a lung malignancy was associated with use of surgical diagnostic approaches. Surgical resection not only afforded reliable diagnoses but also effectively treated PC. There was no need for additional antifungals after complete surgical resection.
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Affiliation(s)
- Bumhee Yang
- Division of Pulmonology, Center of Lung Cancer, National Cancer Center, Goyang, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Taebum Lee
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun-Hyung Kim
- Division of Pulmonology and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Young Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byeong-Ho Jeong
- Division of Pulmonology and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sumin Shin
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seonwoo Kim
- Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - O Jung Kwon
- Division of Pulmonology and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hojoong Kim
- Division of Pulmonology and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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