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Sławiński L, Sołek JM, Miłkowska-Dymanowska J, Jesionek-Kupnicka D, Góra-Tybor J, Mikulski D, Braun M. Primary pulmonary Hodgkin's lymphoma mimicking granulomatosis with polyangiitis - a case report of diagnostic and therapeutic dilemmas. Contemp Oncol (Pozn) 2023; 27:113-117. [PMID: 37794994 PMCID: PMC10546969 DOI: 10.5114/wo.2023.131034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/17/2023] [Indexed: 10/06/2023] Open
Abstract
Primary pulmonary Hodgkin's lymphoma (PPHL) is a rare subtype of lymphoma that comprises a small percentage of primary pulmonary lymphomas. Due to its rarity and nonspecific symptoms, PPHL often presents diagnostic challenges. This case report presents a unique case of PPHL mimicking granulomatosis with polyangiitis, emphasizing the difficulties encountered during the diagnostic process. A 53-year-old female presented with vague symptoms including weakness, oedema, dry cough, and nasal cavity ulceration. Laboratory investigations revealed elevated C-reactive protein levels, a white blood cell count with neutrophilia, and lymphopaenia. Initial treatment with oral corticosteroids for suspected polyangiitis yielded no response. The patient subsequently developed a low-grade fever and pruritic erythematous rash. Diagnostic procedures, including bronchial brush biopsy, bronchial washing, mediastinal lymph node biopsy, nasal cavity ulceration biopsy, and initial lung biopsy, were inconclusive and resulted in exclusion of granulomatosis with polyangiitis. A subsequent computed tomography scan indicated disease progression in the left lung. A lung biopsy revealed fibrotic tissue with nodules containing Hodgkin- Reed-Sternberg cells, leading to the final diagnosis of classic Hodgkin lymphoma, nodular sclerosis subtype. Positron emission tomography scan findings confirmed PPHL. The patient received multiple chemotherapeutic regimens, with brentuximab vedotin demonstrating efficacy as the sole effective treatment. This exceptional case of PPHL underscores the extensive diagnostic and therapeutic workup involving a multidisciplinary team of clinicians, radiologists, and pathologists. Increased awareness of PPHL and its distinctive features will aid in the diagnosis of similar cases in the future, benefitting both clinicians and pathologists.
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Affiliation(s)
- Lucjan Sławiński
- Department of Pathology, Chair of Oncology, Medical University of Łódź, Łódź, Poland
| | - Julia Maria Sołek
- Department of Pathology, Chair of Oncology, Medical University of Łódź, Łódź, Poland
| | | | | | - Joanna Góra-Tybor
- Department of Haematology, Medical University of Łódź and Copernicus Memorial Hospital, Łódź, Poland
| | - Damian Mikulski
- Department of Biostatistics and Translational Medicine, Medical University of Łódź, Łódź, Poland
| | - Marcin Braun
- Department of Pathology, Chair of Oncology, Medical University of Łódź, Łódź, Poland
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Primary pulmonary mucosa-associated lymphoid tissue lymphoma: A case report. Radiol Case Rep 2022; 17:4842-4846. [PMID: 36238212 PMCID: PMC9550531 DOI: 10.1016/j.radcr.2022.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/11/2022] [Indexed: 01/24/2023] Open
Abstract
Primary pulmonary lymphoma (PPL) is a rare entity with the most common presentation as mediastinal lymphadenopathy. The most common form of PPL is Mucosa-Associated Lymphoid Tissue Lymphoma (MALToma) which is an extranodal B-cell lymphoma originating from the mucosal layers involving different organs such as the gastrointestinal tract as well as the lung. Herein, we present a case of a 51-year-old woman with progressive dyspnea for 6 months and no prior medical history. The computed tomography (CT scan) revealed bilateral multifocal consolidation and ground-glass opacities as well as interlobular septal thickening. Bronchoscopy was normal and CT-guided biopsy of lung consolidations was conclusive of MALToma. Complete extrapulmonary evaluations inducing bone marrow aspiration were unremarkable. The primary pulmonary MALToma is an extremely rare entity that presents with non-specific symptoms and a wide variety of CT findings such as mediastinal, hilar lymphadenopathy, and single or multiple lung nodules ranging from 2 to 8 cm. the disease has a favorable prognosis, so prompt diagnosis is essential.
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Peng Y, Qi W, Luo Z, Zeng Q, Huang Y, Wang Y, Sharma A, Schmidt-Wolf IGH, Liao F. Role of 18F-FDG PET/CT in patients affected by pulmonary primary lymphoma. Front Oncol 2022; 12:973109. [PMID: 36185301 PMCID: PMC9515576 DOI: 10.3389/fonc.2022.973109] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Primary pulmonary lymphoma (PPL) is defined as clonal abnormal hyperplasia of lung parenchyma or bronchial lymphoid tissue originating from bronchial mucosal tissue. However, PPL is rare, which accounts for approximately 3-4% of extraneurotic lymphomas and 0.5-1% of all primary tumors in the lung. Owing to the lack of any typical clinical symptoms and radiological features, it is challenging to accurately diagnose PPL, which affects its clinical management and prognosis. Considering this, herein, we aim to raise awareness of this disease and help physicians understand the role of 18F-FDG PET/CT in the diagnosis of PPL. Method A retrospective analysis was performed on the clinical and 18F-FDG PET/CT imaging data of 19 patients diagnosed with PPL by biopsy pathology at our hospital from April 2014 to December 2021. Results Of the 19 PPL patients, 15 patients showed clinical symptoms with the most common being fever and cough. In addition, there were 4 cases that had no clinical symptoms, and all of them were MALT lymphoma. In fact, 16 patients were misdiagnosed as lobar pneumonia, lung cancer, tuberculosis, and diffuse interstitial inflammation, representing a misdiagnosis rate of 84.2%. Also, 73.7% were MALT lymphomas, representing the most common pathological pattern, along with 3 DLBCL and 2 T-cell lymphomas. With reguard to CT signs, the air-bronchial sign was found to be the most common, followed by the halo sign and the collapsed leaf sign. On the basis of the predominant radiologic features, lesions were categorized as pneumonic consolidation, nodular/mass type, diffuse interstitial type, and mixed type. The average SUVmax of lesions was 7.23 ± 4.75, the ratio of SUVmax (lesion/liver) was 3.46 ± 2.25, and the ratio of SUVmax (lesion/mediastinal blood pool) was found to be 5.25 ± 3.27. Of interest, the different pathological types of PPL showed different values of 18F-FDG uptake. The 18F-FDG uptake of DLCBL was the most prominent with a SUVmax of 15.33 ± 6.30 and was higher than that of MALT lymphoma with a SUVmax of 5.74 ± 2.65. There appeared similarity in 18F-FDG uptake between MALT lymphoma and T-cell lymphoma. For the SUVmax of lesion, we found statistical significance between MALT lymphoma and DLCBL (P value<0.001). In addition, we also found statistical significance (P value < 0.05) in SUVmax of lesions between pneumonic consolidation type and nodal/mass type, I stage, and other stages. Conclusions On 18F-FDG PET/CT images, certain features of PPL morphology and metabolism can be identified that may contribute to a better understanding of this disease. In addition, 18F-FDG PET/CT whole-body imaging has the potential to refine the staging of PPL. Most importantly, functional 18F-FDG PET/CT imaging can readily reflect tumor cell activity, thus allowing for the selection of an optimal biopsy site.
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Affiliation(s)
- Ying Peng
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Wanling Qi
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Zhehuang Luo
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Qingyun Zeng
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yujuan Huang
- Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yulu Wang
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany
| | - Amit Sharma
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Ingo G. H. Schmidt-Wolf
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany
| | - Fengxiang Liao
- Department of Nuclear Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Fengxiang Liao,
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Lin H, Zhou K, Peng Z, Liang L, Cao J, Mei J. Surgery and chemotherapy cannot improve the survival of patients with early-stage mucosa-associated lymphoid tissue derived primary pulmonary lymphoma. Front Oncol 2022; 12:965727. [PMID: 36081547 PMCID: PMC9446888 DOI: 10.3389/fonc.2022.965727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background To date, there is no treatment consensus on mucosa-associated lymphoid tissue (MALT) derived primary pulmonary lymphoma (PPL). Methods We identified patients with early-stage MALT-type PPL from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program database. The patients were divided into four groups according to treatment modalities: None of surgery or chemotherapy (None) group, Surgery alone group, Chemotherapy alone (Chemo alone) group, and Surgery plus chemotherapy (Surgery + chemo) group. Overall survival (OS) and cancer-specific survival (CSS) were study endpoints. We performed Cox regression analyses, propensity score-matched analyses (PSM) and Kaplan-Meier (KM) survival curves to compare the survival among different groups. Results A total of 953 patients were included in our analysis with 302, 403, 175, and 73 cases in the None, Surgery alone, Chemo alone, and Surgery + chemo groups, respectively. In this cohort, the estimated 3-year, 5-year and 10-year OS rates were 86.95%, 78.91%, and 55.89%, respectively. Meanwhile, the estimated 3-year, 5-year and 10-year CSS rates were 96.71%, 93.73%, and 86.84%, respectively. Multivariate Cox regression analyses demonstrated that increasing age, tumors located in the lower lobe, and stage II were significant predictors of poorer OS while increasing age and tumors located in the bilateral lungs were associated with lower CSS. After PSM analyses, the KM survival curves showed no significant differences in OS or CSS among the four groups. Conclusion Early-stage MALT-type PPL is indolent in nature. Neither surgery, chemotherapy nor a combination of surgery and chemotherapy can improve OS and CSS, suggesting that “watch and wait” may be a reasonable alternative.
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Affiliation(s)
- Huahang Lin
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Ke Zhou
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Zhiyu Peng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Linchuan Liang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Jie Cao
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Jiandong Mei
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
- *Correspondence: Jiandong Mei,
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Shen H, Zhou Y. Clinical Features and Surgical Treatment of Primary Pulmonary Lymphoma: A Retrospective Study. Front Oncol 2022; 12:779395. [PMID: 35186728 PMCID: PMC8850835 DOI: 10.3389/fonc.2022.779395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/13/2022] [Indexed: 01/08/2023] Open
Abstract
Background Primary pulmonary lymphoma (PPL) is a rare clonal lymphoproliferative lung disease. The present study analyzes the clinical features, imaging data, pathologic characteristics, treatment, and prognosis of PPL patients, with the aim to discuss the appropriate diagnosis and therapy of PPL patients in thoracic surgery. Methods We performed a retrospective analysis on 36 patients with PPL confirmed by postoperative pathology between 2006 and 2020. We divided the patients into low-stage (IE) and high-stage (IIE) groups using modified Ann Arbor staging. The clinical manifestations, imaging findings, treatment modalities, and outcomes were evaluated. Results The female to male ratio was 1.57:1 and the median age was 55 (31–69) years old. The majority of the patients had stage IE disease (75%; 27 of 36) and 9 patients had stage IIE disease. Patients with advancing stage were more likely to have respiratory symptoms. The imaging findings presented solid nodule or mass, pneumonia-like consolidative pattern, ground-glass opacity, and mixed pattern. There were 31 cases of mucosa-associated lymphoid tissue lymphoma (MALT), 2 diffuse large B-cell lymphoma (DLBCL), 2 nodular sclerosing Hodgkin’s lymphoma, and 1 marginal zone B-cell lymphoma. Two patients were diagnosed with PPL and non-small cell lung cancer (NSCLC) synchronously (one AIS and MIS and one lung adenocarcinoma). All the patients received surgery. Nine patients received adjuvant therapy after surgery (five radiotherapy, two chemotherapy, and two chemoradiotherapy). Thirty-four patients had a median follow-up time of 31 months (follow-up range: 7–152 months). Of the 34 patients, 1 patient died of liver metastases and 1 patient died of intestinal metastases. Conclusions Our retrospective analysis suggested that most PPLs were indolent and had favorable prognosis, but the discrimination of PPL with other lung diseases was difficult. Preoperative biopsy and intraoperative frozen section examination might help in the surgical choice. Limited lung resection was enough for peripherally localized PPL.
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Hu M, Gu W, Chen S, Mei J, Wang W. Clinical Analysis of 50 Cases of Primary Pulmonary Lymphoma: A Retrospective Study and Literature Review. Technol Cancer Res Treat 2022; 21:15330338221075529. [PMID: 35253550 PMCID: PMC8905207 DOI: 10.1177/15330338221075529] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed at to raise the awareness understanding of primary pulmonary lymphoma (PPL) by analyzing the clinical manifestation, imaging, pathology, diagnosis, treatment, and prognostic features of 50 cases of PPL. Methods: The study of 50 individuals with PPL diagnosed at the First affiliated hospital of Nanchang university between January 2009 and December 2019 was performed. Results: Overall, 27 males and 23 females were enrolled, with an average age of 57.6 ± 15.6 years. The primary symptoms included, cough (n = 37), expectoration (n = 25), sputum with blood (n = 12), and chest pain (n = 12). Two individuals had Hodgkin's lymphoma and 48 patients had non-Hodgkin's lymphoma (NHL). We divided the NHL cases into mucosa-associated lymphoid tissue lymphoma (MALT) (n = 21), diffuse large B-cell lymphoma (n = 12), small lymphocytic lymphoma (n = 2), mantle B-cell lymphoma (n = 2), follicular lymphoma (n = 1), B-cell lymphoma without further classification (n = 8), and T-cell lymphoma (n = 2). The imaging findings revealed that unilateral lung involvement was more common among the patients. The longest follow-up duration up to December 2019 was 123 months with 40 surviving patients. The 5-year overall survival and progression-free survival were 46.7% and 44.4%, respectively. Age was an independent predictive factor for the 5-year survival (hazard ratio, 8.900; P = .038), (P < .05). Conclusion: PPL is a uncommon disease with atypical clinical manifestations and is often misdiagnosed. Immunohistochemistry is currently the standard used in pathologic evaluation of PPL. MALT prognosis is better in contrast with other kinds of PPL. Surgery or radiotherapy can be considered in patients with limited lesions, and chemotherapy is the first treatment option for diffuse lesions. Age of ≥ 60 years was reported as an independent adverse predictive factor.
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Affiliation(s)
- Mingbin Hu
- 117970Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weiguo Gu
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shaoqing Chen
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinhong Mei
- 117970Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weijia Wang
- 117970Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Sun K, Yu Q, Zhou J, Zhang H, Gao L, Nong L, Wang M, Que C. Primary pulmonary Hodgkin's lymphoma mimicking rheumatoid arthritis-associated organizing pneumonia: A case report. Thorac Cancer 2021; 12:1620-1624. [PMID: 33811475 PMCID: PMC8107033 DOI: 10.1111/1759-7714.13952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/13/2021] [Accepted: 03/14/2021] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Kunyan Sun
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Qing Yu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Jiaxin Zhou
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Hong Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Li Gao
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Lin Nong
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Mangju Wang
- Department of Hematology, Peking University First Hospital, Beijing, China
| | - Chengli Que
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Zhao J, Wang H. Correlation between 18 F-FDG PET/CT semiquantitative parameters and Ki-67 expression in pulmonary mucosa-associated lymphoid tissue lymphoma. J Med Imaging Radiat Oncol 2021; 65:188-194. [PMID: 33538120 DOI: 10.1111/1754-9485.13146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/25/2020] [Indexed: 01/15/2023]
Abstract
INTRODUCTION This study aims to investigate the correlation between 18 F-Fluoro-d-glucose positron emission tomography/computed tomography (18 F-FDG PET/CT) semiquantitative parameters and Ki-67 expression in pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS Twenty-eight patients with histologically confirmed pulmonary MALT lymphoma in 29 lesions who underwent 18 F-FDG PET/CT were retrospectively analysed. PET/CT images were analysed visually and semiquantitatively by measuring maximum standardized uptake value (SUVmax ), mean standardized uptake value (SUVmean ), metabolic tumour volume (MTV) and total lesion glycolysis (TLG). The correlation between morphological pattern, tumour size, Ki-67 expression and PET/CT semiquantitative parameters were also analysed. RESULTS There were 16 male patients (57.1%) and 12 female patients (42.9%), and the mean age was 57.6 ± 9.7 years (range 43-73 years). Twenty-nine pulmonary lesions were identified in 28 patients: 12 (41.4%) presenting as consolidation, 9 (31.0%) as nodules, 5 (17.2%) as masses and 3 (10.3%) as ground glass opacities (GGOs). All of the 29 lesions were 18 F-FDG avid. SUVmax of the lesions was 4.4 ± 3.0 (range 1.1-15.3), SUVmean was 2.8 ± 1.9 (range 0.8-10.3), MTV was 15.9 ± 17.6 (range 0.9-82.1) and TLG was 48.7 ± 56.6 (range 0.9-205.6). The PET/CT semiquantitative parameters were not correlated with morphological pattern of pulmonary MALT lymphoma, which were correlated significantly with tumour size and Ki-67 expression. CONCLUSION Pulmonary MALT lymphomas are 18 F-FDG avid, and 18 F-FDG PET/CT semiquantitative parameters (SUVmax , SUVmean , MTV and TLG) are significantly correlated with tumour size and Ki-67 expression. 18 F-FDG PET/CT plays a potential role in identifying lung MALT lymphomas with higher proliferation and more aggressive behaviour in clinical practice.
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Affiliation(s)
- Juan Zhao
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huoqiang Wang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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He H, Tan F, Xue Q, Liu L, Peng Y, Bai G, Zhang M, Gao S. Clinicopathological characteristics and prognostic factors of primary pulmonary lymphoma. J Thorac Dis 2021; 13:1106-1117. [PMID: 33717584 PMCID: PMC7947551 DOI: 10.21037/jtd-20-3159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Primary pulmonary lymphoma (PPL) is a rare extranodal lymphoma originating from the lung, accounting for 0.5–1.0% of primary lung malignant tumors. Previous case reports or cohort studies included a limited sample size; therefore, the understanding of the disease remains inadequate, and clinical data regarding PPL are limited. Methods Patients with PPL diagnosed histologically and radiologically between January 2000 and December 2019 at our center were retrospectively analyzed. Results In total, 90 consecutive cases were included in this research. Forty-seven (52.2%) patients were female, and the median age was 54 years old. Non-Hodgkin’s lymphoma (PPNHL) was the most common type of PPL (71/90, 78.9%), and mucosa-associated lymphoid tissue (MALT) lymphoma was the most common pathological subtype of PPNHL (56.3%) followed by diffuse large B-cell lymphoma (DLBCL) (32.4%). Thirty-nine (43.3%) patients underwent surgical treatment, and the others received chemotherapy alone or combined with radiotherapy. The estimated 5-year overall survival (OS) rates of MALT lymphoma and non-MALT lymphoma were 68.9% and 65.9%, respectively. Univariate analysis of PPL showed that clinicopathological features that significantly correlated with worse OS were age over 60 years (P=0.006<0.05), elevated LDH (P=0.029<0.05) and β2-MG (P=0.048<0.05) levels, clinical stage II2E and greater (P=0.015<0.05), and nonsurgical treatment (P=0.046<0.05). Age (P=0.013<0.05) was an independent prognostic factor for the 5-year OS of patients through multivariate analysis. Conclusions Age over 60 years old, elevated LDH and β2-MG levels, clinical stage II2E disease or higher, and nonsurgical treatment were associated with poor prognosis in patients with PPL. Age can be used as a potential independent prognostic factor for PPL.
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Affiliation(s)
- Huayu He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Peng
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangyu Bai
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Moyan Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Bi W, Zhao S, Wu C, Gao J, Zhao S, Yang S, Deng Y, Nie P, Yu X, Deng H, Zang X, Ma X, Han J, Asuquo I, Wang X, Xue X. Pulmonary mucosa-associated lymphoid tissue lymphoma: CT findings and pathological basis. J Surg Oncol 2021; 123:1336-1344. [PMID: 33523526 DOI: 10.1002/jso.26403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 12/25/2020] [Accepted: 01/11/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma) is the most frequent subset of primary pulmonary lymphoma. This study aimed to identify radiologic characteristics of pulmonary MALToma based on computed tomography (CT) observations and pathologic features, and further investigate its prognosis. METHODS Sixty-six patients (55.4 ± 10.9 years; 51.5% male) diagnosed as pulmonary MALToma by pathology were retrospectively enrolled. According to distributions and features of lesions shown on CT, patients were divided into three patterns, including single nodular/mass, multiple nodular/mass, and pneumonia-like consolidative. RESULTS Variety of the location and extent of the lymphomatous infiltration accounted for different characteristics demonstrated at CT. The pneumonia-like consolidative pattern was the most frequent pattern observed in 42 patients (63.6%), followed by single nodular/mass (21.2%) and multiple nodular/mass (15.2%). CT features included air bronchogram (72.7%), well-marginated halo sign (53.0%), coarse spiculate with different lengths (72.7%), angiogram sign (77.1% of 35 patients), peribronchovascular thickening (48.5%), irregular cavitation (16.7%) and pulmonary cyst (7.6%). The estimated 5-year cumulative overall survival rate of pulmonary MALToma was 100.0%. CONCLUSIONS Pulmonary MALToma demonstrates several characteristics at CT. Identification of the significant pulmonary abnormalities of this indolent disease entity might be helpful for early diagnosis and optimal treatment.
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Affiliation(s)
- Wanli Bi
- Department of Radiology, Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Shuo Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chongchong Wu
- Department of Radiology, The Chinese PLA General Hospital, Beijing, China
| | - Jie Gao
- Department of Pathology, The Chinese PLA General Hospital, Beijing, China
| | - Shaohong Zhao
- Department of Radiology, The Chinese PLA General Hospital, Beijing, China
| | - Shifeng Yang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yan Deng
- Department of Radiology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Pei Nie
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xinxin Yu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hui Deng
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xuelei Zang
- Department of Microbiology, The Chinese PLA General Hospital, Beijing, China
| | - Xidong Ma
- Department of Respiratory Disease, School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Jun Han
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Idorenyin Asuquo
- Department of and Respiratory, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinying Xue
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Peking University Ninth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care, Chinese PLA General Hospital, Beijing, China
- Affiliated Hospital of Weifang Medical University, Shandong, China
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11
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Rabadão T, Naia L, Ferreira F, Teixeira M, Aveiro M, Eulálio M, Silva F. Not Always (and Only) Heart Failure-A Case Report of Primary Pleural Lymphoma in an Elderly Patient. Clin Pract 2021; 11:32-36. [PMID: 33572698 PMCID: PMC7930994 DOI: 10.3390/clinpract11010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 11/30/2022] Open
Abstract
Pleural involvement in Non-Hodgkin Lymphoma (NHL) is well documented, but primary pleural lymphomas are extremely rare, occurring mostly in immunosuppressed patients or associated with chronic pleural inflammation. Nevertheless, the pathogenesis and therapeutic approaches to counteract primary pleural lymphomas are still matter of debate. The authors present the clinical case of an 81-year-old female with respiratory and constitutional symptoms. A valvular heart disease and bilateral pleural effusion were known. The study carried out showed a large right pleural effusion; the fluid analysis was compatible with Diffuse Large B-cell Lymphoma (DLBCL), and two lymphomatous masses with pleural origin were found at the ipsilateral hemithorax. Primary pleural lymphoma was considered and chemotherapy was initiated with a good response and evolution. The authors report this remarkable clinical case because of its rarity, its excellent clinical evolution and the absence of an immunodeficiency context.
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Affiliation(s)
- Tiago Rabadão
- Medicine Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal; (L.N.); (F.F.); (M.T.); (M.A.); (M.E.)
- Correspondence:
| | - Leonor Naia
- Medicine Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal; (L.N.); (F.F.); (M.T.); (M.A.); (M.E.)
| | - Filipa Ferreira
- Medicine Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal; (L.N.); (F.F.); (M.T.); (M.A.); (M.E.)
| | - Mariana Teixeira
- Medicine Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal; (L.N.); (F.F.); (M.T.); (M.A.); (M.E.)
| | - Marcelo Aveiro
- Medicine Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal; (L.N.); (F.F.); (M.T.); (M.A.); (M.E.)
| | - Margarida Eulálio
- Medicine Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal; (L.N.); (F.F.); (M.T.); (M.A.); (M.E.)
| | - Fernando Silva
- Hematology Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal;
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12
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Mohapatra S, Padhi S, Panigrahi M, Mishra P, Patra S, Sable M, Thakur B, Nayak M, Panigrahi A. Pulmonary anaplastic large-cell lymphoma: A case-based systematic review of world literature. J Cancer Res Ther 2021; 17:1297-1306. [DOI: 10.4103/jcrt.jcrt_1089_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Chowdhary G, Mehta R, Tyagi R. Primary pulmonary Hodgkin's lymphoma with pulmonary histoplasmosis. Med J Armed Forces India 2020; 76:462-465. [PMID: 33162658 PMCID: PMC7606111 DOI: 10.1016/j.mjafi.2018.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022] Open
Abstract
Primary pulmonary Hodgkins lymphoma is a rare and enigmatic neoplasm commonly seen in females. The aim of this case report is to emphasize that pulmonary lymphoma should be considered as a differential diagnosis in a young patient presenting with a lung mass and B symptoms. Extensive clinical details, imaging should be done to rule out the secondary involvement of lung by other lymphomas.
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Affiliation(s)
- G.S. Chowdhary
- Senior Advisor (Medicine & Oncology), INHS Asvini, Mumbai, India
| | - Ritu Mehta
- Classified Specialist (Pathology & Oncopathology), INHS Asvini, Mumbai, India
| | - Rahul Tyagi
- Classified Specialist (Pulmonary Medicine), INHS Asvini, Mumbai, India
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14
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Xie X, Zhang L, Wu M, Kang Z, Yan H, Zhang X, Shen W, Dong M. A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma. Transl Cancer Res 2020; 9:1969-1977. [PMID: 35117543 PMCID: PMC8798910 DOI: 10.21037/tcr.2020.02.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/04/2020] [Indexed: 12/20/2022]
Abstract
Background The retrospective study was mainly performed to determine the clinical symptoms and radiological characteristics of primary pulmonary lymphoma (PPL) to improve the recognition and diagnosis of the disease. Methods Between June 2007 and June 2019, the clinical data and radiological images of the 16 patients with PPL confirmed by pathology were retrospectively analyzed. Results Among the 16 patients with PPL (6 males and 10 females, aged 32 to 72 years, with a median age of 55.13 years), 9 patients were mucosa-associated lymphoid tissue lymphoma (MALT) and 7 patients were diffuse large B-cell lymphoma (DLBCL); all of the patients did not suffer from autoimmune disease [such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or Sjogren’s syndrome (SSS)]; and 11 patients had a long-term smoking history from 10 to 40 years. The common clinical symptoms were as follows: chest discomfort (n=8), cough (n=10), chest pain (n=7), fever (n=6), apnea (n=1), fatigue (n=4) and weight loss (n=3), however, 6 cases did not show clear symptoms at the time of diagnosis. Blood tests revealed anemia (n=6), thrombocytopenia (n=2), lactate dehydrogenase (LDH) level (n=7), C-reactive protein (CRP) (n=9), erythrocyte sedimentation rate (ESR) (n=8) and no tumor-related indexes were detected abnormal. The chest radiological images showed a total of 8 cases with multiple masses, 2 cases with different types of nodes, 4 cases with patchy infiltration or consolidation shadow, with or without an air bronchogram, and 2 cases with a mixed manifestation. All the lesions were only involved in unilateral lung (13 right, 3 left), none of them located on bilateral lung fields. At the time of admission, the patients were misdiagnosed as lung cancer (n=9), pneumonia (n=5), tuberculosis (n=1), and diffuse interstitial lung disease (n=1). Then final pathological diagnosis was confirmed by surgery (n=9), percutaneous lung biopsy (n=5), and bronchoscopic biopsy (n=2). Conclusions PPL is a rare disease, though clinical symptoms and radiological characteristics are not typical, they serve as significant clues for the diagnosis and differential diagnosis. Accurate diagnosis mainly depends on histopathological examination, however, conducting a retrospectively study could improve and enrich our knowledge to the disease and reduce inappropriate treatments.
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Affiliation(s)
- Xiaodong Xie
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Lei Zhang
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Mengjie Wu
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Zheng Kang
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Hongwei Yan
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Xiuming Zhang
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Wenrong Shen
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Min Dong
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
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15
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Low SK, Zayan AH, Istanbuly O, Nguyen Tran MD, Ebied A, Mohamed Tawfik G, Huy NT. Prognostic factors and nomogram for survival prediction in patients with primary pulmonary lymphoma: a SEER population-based study. Leuk Lymphoma 2019; 60:3406-3416. [PMID: 31322026 DOI: 10.1080/10428194.2019.1633636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Primary pulmonary lymphomas (PPLs) are rare lymphoproliferative malignancies arising from the lungs. The prognostic factors and optimal management of PPL have not been clearly defined due to its rarity. This study sought to characterize the significant prognostic factors and develop a validated nomogram for individualized prediction of survival outcomes in patients with PPL. A total of 2325 patients diagnosed with PPL between 1983 and 2010 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Older age at diagnosis, males, Hispanic race, non-marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue histology, Ann Arbor stage IV were significantly associated with worse OS on multivariable analysis. All treatment modalities, including chemotherapy, surgery, and radiotherapy were independent predictors of survival on univariable analysis. The nomogram built demonstrated good discriminative ability and calibration, with the C-index of 0.690 and 0.730 in the training and validation cohorts, respectively.
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Affiliation(s)
- Soon Khai Low
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | | | - Obaida Istanbuly
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Minh Duc Nguyen Tran
- Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Amr Ebied
- Egyptian National Blood Transfusion Services, Cairo, Egypt
| | | | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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16
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Abstract
Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is the most common primary pulmonary lymphoma. There are limited studies on imaging features of pulmonary MALT lymphoma. We present the computed tomography (CT) manifestations of pulmonary MALT lymphoma and the correlation between CT manifestations and clinical characteristics. Patients (n = 53) with histologically confirmed pulmonary MALT lymphoma who underwent chest CT scanning were retrospectively analyzed. Evaluated findings included distribution of pulmonary lesions, morphological pattern of appearance, contrast enhancement features, size, presence of thoracic lymphadenopathy, and secondary associated features. Pulmonary MALT lymphoma was observed in multiple (79%) and bilateral (66%) disease with random distribution (≥70%) of pulmonary lesions. The most frequent morphological pattern was consolidation (n = 33, 62%), followed by nodule (n = 23, 43%) and mass (n = 11, 21%). Common associated features were air bronchograms and bronchiectasis, especially cystic bronchiectasis and angiogram sign. Asymptomatic patients had less consolidation and bronchiectasis than did symptomatic patients. Cystic bronchiectasis was only observed in the symptomatic group. In conclusion, pulmonary MALT lymphoma manifests as diverse patterns on CT scans. Consolidation combined with cystic bronchiectasis was a characteristic late sign, which may assist in differential diagnosis. High-resolution CT images and multiplanar reconstruction techniques are helpful for accurately determining imaging manifestations.
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17
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Qian J, Luo DL, Zhang JE, Li WY, Gao XL, Fang XF, An H, Deng JL, Li Q, Wu J. Diagnostic and prognostic factors for patients with primary pulmonary non-Hodgkin's lymphoma: A 16-year single-center retrospective study. Oncol Lett 2019; 18:2082-2090. [PMID: 31423281 DOI: 10.3892/ol.2019.10469] [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] [Received: 07/01/2018] [Accepted: 04/29/2019] [Indexed: 12/14/2022] Open
Abstract
Primary pulmonary non-Hodgkin's lymphoma (PP-NHL) is a rare entity with non-specific symptoms and radiographic findings, as well as a difficult preoperative diagnosis. A limited number of studies have described PP-NHL in Chinese patients. The goal of the present study was to improve early diagnosis by examining prognostic factors in patients with PP-NHL. Therefore, a total of 29 patients with PP-NHL were included in the study between January 2001 and June 2017, including 14 with aggressive-type and 15 with indolent-type lymphomas (10 male, 19 female; median age, 50.3 years; range, 19-87 years). Pulmonary nodules and masses (55.2%) were the most common radiographic features. The diagnostic yield was 80% (12/15) by endobronchial biopsy or transbronchial lung biopsy and 100% by computed tomography (CT)-guided percutaneous needle lung biopsy (11/11) or surgery (8/8). Elevated lactate dehydrogenase levels and systemic symptoms were observed considerably more often in patients with aggressive disease than in those with indolent disease. The 1-, 3- and 5-year overall survival (OS) rates were 42, 32, and 21%, respectively, for all patients, 72, 57 and 43%, respectively, for patients with indolent lymphomas, and 13, 6 and 0%, respectively, for patients with aggressive lymphomas. The median OS rate for all patients was 12.0 months; however, the OS rate for patients with aggressive lymphomas was significantly shorter compared with those with indolent lymphomas (7.1 months vs. 16.6 months; P=0.002). Aggressive vs. indolent lymphoma status was indicated to be an independent prognostic factor for poor 5-year OS rate (hazard ratio, 5.98; P=0.014). In conclusion, bronchoscopic and CT-guided percutaneous needle lung biopsies were the most useful and least invasive procedures for diagnosing PP-NHL. Furthermore, aggressive PP-NHL was highly associated with poor 5-year OS rate and a poor prognosis.
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Affiliation(s)
- Jiang Qian
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China.,Department of Oncology, Chizhou People's Hospital, Chizhou, Anhui 247100, P.R. China
| | - Dong-Lan Luo
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Jin-E Zhang
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Wen-Yu Li
- Department of Lymphoma, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Xing-Lin Gao
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Xiang-Feng Fang
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Hong An
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Jun-Liang Deng
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Qiong Li
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
| | - Jian Wu
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
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18
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Yang M, Ping L, Liu W, Xie Y, Aliya, Liu Y, Nuersulitan R, Zhu J, Wu M, Song Y. Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study. ACTA ACUST UNITED AC 2019; 24:413-419. [PMID: 30922173 DOI: 10.1080/16078454.2019.1598678] [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: 02/03/2023]
Abstract
OBJECTIVES To analyze the clinical characteristics and prognosis of primary extranodal classical Hodgkin lymphoma (PE-cHL). METHODS Clinical features and outcomes of 22 PE-cHL patients who received initial chemotherapy January 2008 to January 2018 were analyzed retrospectively, and compared with 274 primary nodal Hodgkin lymphoma (PN-cHL) patients treated in the same period. RESULTS With a median follow-up period of 42 months, compared with 274 PN-cHL patients, no significant difference of overall response rate (ORR) or complete remission (CR) rate was found, but the PE-cHL patients showed a higher recurrence rate (36.4% vs. 13.1%, p = .003) and poorer survival [(5-year overall survival (OS) rate: 64.6% vs. 97.7%, p = .001; 5-year progression-free survival (PFS) rate: 42.4% vs. 82.2%, p < .001)]. To minimize the effects of confounding factors, PE-cHL patients were matched with PN-cHL patients at a ratio of 1:1 according to age, gender, histological types and stage. Compared with 22 matched PN-cHL cases, PE-cHL was still associated with poor PFS (5-year PFS: 42.4% vs. 79.9%, p = .004). As to 22 PE-cHL patients, univariate analysis showed elevated serum lactate dehydrogenase (LDH) and elevated platelet (PLT) were associated with poor PFS (p < .05). DISCUSSION Compared with PN-cHLs, PE-cHLs showed a considerable shorter duration of remission, higher recurrence tendency and poorer survival, indicating that more intensive therapy may be needed. CONCLUSION The prognosis of PE-cHL is unfavorable. Elevated LDH and PLT are poor prognostic factors for PE-cHL.
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Affiliation(s)
- Mingzi Yang
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Lingyan Ping
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Weiping Liu
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Yan Xie
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Aliya
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Yanfei Liu
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Reyizha Nuersulitan
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Jun Zhu
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Meng Wu
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
| | - Yuqin Song
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma , Peking University Cancer Hospital & Institute , Beijing , People's Republic of China
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19
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A young man with an unchanged consolidation in chest CT. Respir Med Case Rep 2019; 26:150-153. [PMID: 30603607 PMCID: PMC6307102 DOI: 10.1016/j.rmcr.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/23/2022] Open
Abstract
Primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare. MALT lymphoma patients usually show no clinical symptoms or physical signs. Chest radiograph or computed tomography (CT) may confuse MALT lymphoma with other pulmonary diseases, which would lead to misdiagnosis or a delayed diagnosis. In the present study, a 33-year-old male patient had cough and fever. Chest CT showed consolidation on both sides. Those clinical symptoms disappeared after he had been misdiagnosed and treated for community-acquired pneumonia for three weeks. However, further chest CT still showed the consolidation without any change. Then an ultrasonic guided transthoracic needle biopsy was performed. Morphological changes indicated the diagnosis of extranodal marginal Zone B cell lymphoma of MALT. The patient was then treated with chemotherapy and rituximab. After this line of treatment, the consolidation decreased.
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20
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Abstract
A 57-year-old man had a diagnosis of a bronchial mucosa-associated lymphoid tissue lymphoma in the left lung and monoclonal gammopathy. The patient underwent whole-body C-methionine PET/CT, in order to evaluate the amino acid avidity of the lesion and to stage the bronchial mucosa-associated lymphoid tissue lymphoma. C-methionine uptake was detected in the lung lesion and in the mediastinal lymph nodes.
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21
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Byers JT, Kurtz JL, Mendoza AS, Oster CD, Sun NCJ, Qing X, Cornford ME. An unusual presentation of primary pulmonary extranodal marginal zone lymphoma of mucosal associated lymphoid tissue: An autopsy case report. Exp Mol Pathol 2018; 104:155-157. [PMID: 29452080 DOI: 10.1016/j.yexmp.2018.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 02/12/2018] [Indexed: 11/16/2022]
Abstract
A 40 year old female with no documented medical history presented to the Emergency Department with several days of lethargy and altered mental status. She was found to be anemic, thrombocytopenic, and hypotensive. The patient was found to be in severe metabolic acidosis, became bradycardic, and quickly deteriorated. Clinicians suspected thrombotic thrombocytopenic purpura, and the diagnosis was supported by ADAMTS13 testing. The clinicians attempted to place a Quinton catheter for emergent plasmapheresis, but the patient expired before definitive treatment could be initiated. Autopsy was obtained and revealed a right middle lobe consolidation grossly consistent with lymphoid tissue or tumor.
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Affiliation(s)
- Joshua T Byers
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States.
| | - Justin L Kurtz
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States
| | - Alejandro S Mendoza
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States
| | - Cyrus D Oster
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States
| | - Nora C J Sun
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States
| | - Xin Qing
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States
| | - Marcia E Cornford
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance, CA, United States
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22
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Aguiar-Bujanda D, Ros-Sanjuan L, Hernandez-Sosa M, Perera-Romero C. An unexpected diagnosis in a patient with new-onset pulmonary infiltrates during adjuvant therapy for breast cancer. Oxf Med Case Reports 2018; 2018:omx095. [PMID: 29479451 PMCID: PMC5806405 DOI: 10.1093/omcr/omx095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/17/2017] [Indexed: 11/22/2022] Open
Abstract
The differential diagnosis of new-onset pulmonary infiltrates during adjuvant therapy in a cancer patient is challenging. Opportunistic infections, pulmonary drug-induced toxicity and metastatic dissemination of the underlying cancer are the most common causes. However, although infrequent, the development of a second primary pulmonary neoplasia should be taken into account. We present the clinical case of a breast cancer patient who developed progressive pulmonary infiltrates during adjuvant therapy, who was finally diagnosed as having a second lung neoplasm of unexpected histology.
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Affiliation(s)
- David Aguiar-Bujanda
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
- Correspondence address. Department of Medical Oncology. Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria. Spain. Tel: +34-928-450400; Fax: +34-928-450079; E-mail:
| | - Laura Ros-Sanjuan
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
| | - Maria Hernandez-Sosa
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
| | - Carmen Perera-Romero
- Department of Nuclear Medicine, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
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23
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Dong Y, Zeng M, Zhang B, Han L, Liu E, Lian Z, Liu J, Liang C, Zhang S. Significance of imaging and clinical features in the differentiation between primary and secondary pulmonary lymphoma. Oncol Lett 2017; 14:6224-6230. [PMID: 29113271 PMCID: PMC5661413 DOI: 10.3892/ol.2017.6962] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 07/11/2017] [Indexed: 02/05/2023] Open
Abstract
The aim of the present study was to analyze the differences in imaging and clinical features between primary pulmonary lymphoma (PPL) and secondary pulmonary lymphoma (SPL) to provide insight into pulmonary lymphoma for an improved clinical diagnosis. A retrospective study of 38 patients with pulmonary lymphoma (19 PPL and 19 SPL) treated between September 1, 2006, and December 31, 2015, was performed. The clinical manifestations, and computed tomography (CT) and positron emission tomography-CT images of each case were collected. χ2 and Fisher's exact tests were applied to assess statistically significant differences between PPL and SPL in terms of clinical and imaging features. The significant variables were further applied to canonical discriminate analysis. The CT results revealed that the occurrence of a >3-cm mass (P=0.007), peripheral location (lower than the segmental bronchi) (P=0.027), cavitation (P=0.008) and consolidation (P=0.027) were associated with PPL, while peripheral and hilar location (P=0.003) or mediastinal and hilar lymph node engagement (P=0.044) were predominantly observed in SPL. However, no significant differences between clinical manifestations and the maximum standard uptake value of pulmonary lesions in PPL and SPL were identified (all P>0.05). A function derived from discriminate analysis was generated that may predict the affiliation to PPL or SPL radiographically, with an overall accuracy of ≤92.1%. The results of the present study revealed that PPL and SPL exhibit distinctive features on CT images due to distinct molecular mechanisms and growth patterns. Careful observation of CT features may be useful in the diagnosis of PPL and SPL regarding the tumor morphology, location and lymph node involvement.
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Affiliation(s)
- Yuhao Dong
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
- Graduate College, Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - Miaoyu Zeng
- Graduate College, Southern Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Bin Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
- Graduate College, Southern Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Lujun Han
- Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510120, P.R. China
| | - Entao Liu
- Department of Nuclear Medicine, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
| | - Zhouyang Lian
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
- Graduate College, Southern Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Jing Liu
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
- Graduate College, Southern Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Changhong Liang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
| | - Shuixing Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong 510080, P.R. China
- Correspondence to: Dr Shuixing Zhang, Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, 106 Zhongshan Er Road, Guangzhou, Guangdong 510080, P.R. China, E-mail:
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Sinha A, Patti R, Singh P, Solomon W, Kupfer Y. A Diagnostic Surprise: Primary Hodgkin's Lymphoma of the Lung. J Investig Med High Impact Case Rep 2017; 5:2324709617734247. [PMID: 29051894 PMCID: PMC5637979 DOI: 10.1177/2324709617734247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 08/19/2017] [Indexed: 11/25/2022] Open
Abstract
An 81-year-old male presented to the emergency room with a 3-month history of progressive shortness of breath, productive cough with white sputum, and generalized weakness with 10-pound weight loss in 2 months. On presentation, the patient was afebrile, with blood pressure of 93/55 mm Hg and oxy-hemoglobin saturation of 92% on 2 liters of oxygen via nasal cannula. Complete blood count with differential was significant for white count of 12 400/mL. Brain natriuretic peptide level was 454 ng/mL. Postero-anterior chest radiograph showed multiple round opacities in the lung fields. Computed tomography scan of the chest confirmed multiple round densities in both the lung fields along with mild mediastinal lymphadenopathy. Core needle biopsy was performed. Immunohistochemical stains were positive for CD30 and CD15 in a population of large atypical cells amid a background of CD3-positive nonneoplastic cells. These results were in support of the diagnosis of classical Hodgkin’s lymphoma of the lung with histological appearance confirming nodular sclerosis type. The patient was started on chemotherapy but was readmitted in 20 days for acute respiratory distress and suffered cardiac arrest and subsequently died. This case highlights the fact that although primary pulmonary Hodgkin’s lymphoma of the lung is a rare entity, it should be thought of as a differential while evaluating lung masses. In these cases, definite diagnosis can only be made by biopsy and histology. Early commencement of chemotherapy and regular follow-up with oncology is essential.
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Affiliation(s)
- Ankur Sinha
- Maimonides Medical Center, Brooklyn, NY, USA
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25
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Albano D, Borghesi A, Bosio G, Bertoli M, Maroldi R, Giubbini R, Bertagna F. Pulmonary mucosa-associated lymphoid tissue lymphoma: 18F-FDG PET/CT and CT findings in 28 patients. Br J Radiol 2017; 90:20170311. [PMID: 28830222 DOI: 10.1259/bjr.20170311] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the CT and fluorine-18-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) imaging findings of lung mucosa associated lymphoid tissue (MALT) lymphoma. METHODS 28 patients with histologically confirmed pulmonary MALT lymphoma who underwent a chest CT and 18F-FDG PET/CT for staging were retrospectively analysed. The CT images were evaluated to determine morphological pattern of appearance, laterality, localization, number, size, presence of thoracic lymphadenopaties and secondary/combined findings. PET images were analysed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax), lesion-to-liver SUVmax ratio and lesion-to-blood pool SUVmax ratio. The relationship between qualitative and semi-quantitative features at 18F-FDG PET/CT and CT findings were also analysed. RESULTS A total of 57 pulmonary lesions were identified by CT: 37 areas of consolidation, 4 masses, 12 nodules and 4 ground-glass opacities. Solitary and multiple lesions were detected in 10 and 18 patients, respectively; among patients with multiple lesions, 16 were bilateral and 2 unilateral. 18F-FDG PET/CT revealed increased 18F-FDG uptake in 47/57 lesions, in 26/28 patients. 18F-FDG avidity was significantly associated only with tumour size. CONCLUSIONS Pulmonary MALT lymphoma is 18F-FDG avid in most cases and 18F-FDG avidity is correlated with tumour size. Consolidation is the most frequent morphological pattern of disease presentation. Advances in knowledge: This study demonstrated that lung MALT lymphoma are 18F-FDG avid in most cases depending on tumour size. Single or multiple areas of consolidation are the most common pattern of presentation of lung MALT lymphoma at CT.
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Affiliation(s)
| | - Andrea Borghesi
- 2 Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Giovanni Bosio
- 1 Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy
| | - Mattia Bertoli
- 1 Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy
| | - Roberto Maroldi
- 2 Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Raffaele Giubbini
- 3 Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Francesco Bertagna
- 3 Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
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26
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Delgado Torralbo JA, García Gómez LC, Sánchez Varilla JM. Unilateral lung infiltrate: A rare form of presentation of primary pulmonary lymphoma. Arch Bronconeumol 2017; 54:103-104. [PMID: 28757282 DOI: 10.1016/j.arbres.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/11/2017] [Accepted: 06/14/2017] [Indexed: 11/27/2022]
Affiliation(s)
| | - Luis Carlos García Gómez
- Servicio de Neumología, Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Juan Manuel Sánchez Varilla
- Servicio de Neumología, Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España
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27
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Abstract
Primary pulmonary lymphomas represent a pathologically heterogeneous group of disorders that often share imaging features, which include peribronchovascular nodules and masses or areas of nonresolving consolidation. Primary mediastinal B-cell lymphoma is an extranodal non-Hodgkin lymphoma seen in younger patients that has imaging and pathologic features that demonstrate some degree of overlap with Hodgkin lymphoma. Primary lymphomas of the pleural space are rare and associated with concomitant viral infections.
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28
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Saqib A, Ibrahim U, Maroun R. Primary Pulmonary Lymphoma and Synchronous Cecal Adenocarcinoma: A Rare Occurrence. Cureus 2016; 8:e944. [PMID: 28133582 PMCID: PMC5268376 DOI: 10.7759/cureus.944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the era of extensive imaging and increasing indications for performing PET-CT scans, the recognition of synchronous tumors may be greater than before. However, the majority of these tumors are seen to occur in the same organ system, likely because of sharing similar pathogenic mechanisms. Synchronous lung cancers of similar or differing histologies have been reported. Primary pulmonary lymphoma, which is a rare form of non-Hodgkin’s lymphoma, has also been seen with a synchronous primary lung cancer. However, we report a case of a 56-year-old male diagnosed with primary pulmonary lymphoma and on PET-CT imaging, found to have a cecal lesion, the biopsy of which showed adenocarcinoma. We discuss the incidence of the co-existence of multiple tumors, the pathogenic mechanisms involved, and approaches to the management of these rare clinical scenarios.
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Affiliation(s)
- Amina Saqib
- Pulmonary/Critical Care, Staten Island University Hospital
| | - Uroosa Ibrahim
- Department of Hematology/Oncology, Staten Island University Hospital
| | - Rabih Maroun
- Pulmonary/Critical Care, Staten Island University Hospital
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29
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Tanriverdi E, Acat M, Ozgul G, Abbasli K, Gul S, Yasar Z, Cortuk M, Fener NA, Akin H, Ozgul MA, Cetinkaya E. Primary pulmonary lymphoma: four different and unusual radiologic and clinical manifestations. Leuk Lymphoma 2016; 58:1231-1233. [PMID: 27658461 DOI: 10.1080/10428194.2016.1225210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Elif Tanriverdi
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Murat Acat
- b Department of Chest Diseases , Karabük University Faculty of Medicine , Karabük , Turkey
| | - Guler Ozgul
- c Department of Chest Diseases , Bağcılar Education and Research Hospital , İstanbul , Turkey
| | - Kenan Abbasli
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Sule Gul
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Zehra Yasar
- d Department of Chest Diseases , Abant İzzet Baysal University Faculty of Medicine , Bolu , Turkey
| | - Mustafa Cortuk
- b Department of Chest Diseases , Karabük University Faculty of Medicine , Karabük , Turkey
| | - Neslihan Akanil Fener
- e Department of Pathology , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Hasan Akin
- f Department of Thoracic Surgery , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Mehmet Akif Ozgul
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Erdogan Cetinkaya
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
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30
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Fu T, Yang W, Zhang X, Xu X. Peripheral T-cell lymphoma unspecified type presenting with a pneumothorax as the initial manifestation: A case report and literature review. Oncol Lett 2016; 11:4069-4076. [PMID: 27313743 DOI: 10.3892/ol.2016.4518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 01/13/2016] [Indexed: 11/05/2022] Open
Abstract
The present study describes the case of a 51-year-old male presenting with a pneumothorax, in whom a final diagnosis of peripheral T-cell lymphoma unspecified type (PTCL-u) was determined. As the patient had experienced a shortness of breath subsequent to exercise for a period of 2 months, a fiber bronchoscopy was performed; however, no abnormalities were initially identified. Following the bronchoscopy, the patient suffered a recurrent pneumothorax with symptoms of emaciation, night sweats and a fever. The combination of computed tomography and interstitial lung pathology results suggested a high probability of malignant lymphoma. Further test results confirmed this diagnosis, including the fiber bronchoscopy biopsy report, which indicated a large amount of lymphocyte aggregation, and an ultrasound that identified several supraclavicular and left submandibular enlarged lymph nodes (largest size, 2.3×1.3 cm), with an absent hilar lymph node. A biopsy of the left cervical lymph node was performed, with post-operative pathological analysis confirming a diagnosis of peripheral T-cell lymphoma unspecified (stage IVB). The patient received two cycles of CHOP chemotherapy, and the symptoms alleviated following completion of the treatment, with chest radiography indicating that the pneumothorax had disappeared. The patient subsequently refused further treatment due to financial difficulty, and succumbed to the disease 6 months later.
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Affiliation(s)
- Tianhong Fu
- Division of Pathology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Wei Yang
- Division of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Xuejin Zhang
- Division of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiaofeng Xu
- Division of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
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31
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Abstract
An overview of the pathology of extranodal lymphoma is presented. The emphasis of this presentation is on the classification system of extranodal lymphomas, including both B-cell and T-cell lymphomas, based on their morphology, phenotype, and molecular alterations.
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32
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Abstract
PURPOSE OF REVIEW Despite the fact that primary pulmonary lymphoma (PPL) is a rare lung tumour, significant advances addressing clinical features, histological diagnosis, prognostic criteria and therapeutic management of this disease have been made within the past decade. RECENT FINDINGS Monoclonality and phenotyping of alveolar lymphocytes are suggestive of mucosa-associated lymphoid tissue (MALT). Detection of MALT-1 gene rearrangements in bronchoalveolar fluid cells using fluorescence in-situ hybridization techniques helps to confirm the diagnosis of MALT PPL. Fine needle aspiration-computed tomography guided biopsies as well as transbronchial/cryobiopsies provide adequate tissue material for histological evaluation. Recent publications also provide a better appreciation of newer chemotherapeutic approaches, including fludarabine and mitoxantrone with or without ritubximab for the treatment of MALT, as well as complete surgical resection if local disease is present. Prognostic factors influencing survival and optimal therapy for MALT have not been well defined, but the use of tumour microvascular density appears promising. SUMMARY This review outlines the implications of recent findings for clinical practice and research progress of PPL. Larger, multicentre and well designed studies are imperative to optimize the current diagnostic and therapeutic approach for this disease.
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33
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Tanveer S, El Damati A, El Baz A, Alsayyah A, ElSharkawy T, Regal M. Primary Pulmonary Hodgkin Lymphoma. Rare Tumors 2015; 7:5968. [PMID: 26788271 PMCID: PMC4703917 DOI: 10.4081/rt.2015.5968] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 05/14/2015] [Accepted: 05/26/2015] [Indexed: 11/23/2022] Open
Abstract
Primary pulmonary Hodgkin lymphoma (PPHL) is a rare disease. Herein, we report a case of PPHL with diagnostic concerns encountered during initial evaluation which is of paramount importance to keep the differential diagnosis in cases with high index of suspicion for this rare entity.
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Affiliation(s)
- Shumaila Tanveer
- Cardiothoracic Surgery Unit, Department of Surgery, King Fahd University Hospital, King Faisal University , Al Khobar
| | - Ahmed El Damati
- Cardiothoracic Surgery Unit, Department of Surgery, King Fahd University Hospital, King Faisal University , Al Khobar
| | - Ayman El Baz
- Cardiothoracic Surgery Unit, Department of Surgery, King Fahd University Hospital, King Faisal University , Al Khobar
| | - Ahmed Alsayyah
- Department of Pathology, King Fahad University Hospital, University of Dammam , Saudi Arabia
| | - Tarek ElSharkawy
- Department of Pathology, King Fahad University Hospital, University of Dammam , Saudi Arabia
| | - Mohamed Regal
- Cardiothoracic Surgery Unit, Department of Surgery, King Fahd University Hospital, King Faisal University , Al Khobar
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34
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Straughan DM, Kerkar S, Azoury SC, Reardon ES, Schrump DS. Pulmonary mucosa-associated lymphoma in a patient with von Hippel-Lindau disease. J Surg Case Rep 2015; 2015:rjv080. [PMID: 26173437 PMCID: PMC4500894 DOI: 10.1093/jscr/rjv080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A 61-year-old female with a past medical history significant for von Hippel–Lindau (VHL) syndrome presented with multiple bilateral pulmonary lesions found on surveillance computed tomography scan. Positron emission tomography demonstrated avidity in a lesion in the right upper lobe. After an equivocal biopsy, a lobectomy via a thoracoscopic approach was performed as this lesion was concerning for a primary lung cancer. Pathology revealed a diagnosis of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. To our knowledge, this is the first reported case of a pulmonary MALT lymphoma in a patient with VHL.
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Affiliation(s)
- David M Straughan
- Department of Thoracic and GI Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sid Kerkar
- Department of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Saїd C Azoury
- Department of Thoracic and GI Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Emily S Reardon
- Department of Thoracic and GI Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - David S Schrump
- Department of Thoracic and GI Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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35
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Shinoda K, Taki H, Tsuda T, Hayashi R, Nomoto K, Tobe K. Primary pulmonary lymphoma presenting with multiple lung nodules. Am J Respir Crit Care Med 2014; 190:e30-1. [PMID: 25360736 DOI: 10.1164/rccm.201401-0086im] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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36
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Mian M, Wasle I, Gritsch S, Willenbacher W, Fiegl M. B cell lymphoma with lung involvement: what is it about? Acta Haematol 2014; 133:221-5. [PMID: 25376208 DOI: 10.1159/000365778] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 07/04/2014] [Indexed: 01/22/2023]
Abstract
Primary lymphoma of the lung or pleural is a very rare condition. Due to the outdated literature data, the approximate occurrence of primary and secondary lung and/or pleural involvement according to the most common B cell lymphoma entities is unknown. To answer this open question in Austria, we screened the Tyrolean registry for B cell non-Hodgkin's lymphomas regarding primary and secondary lung involvement. Of 854 patients affected by B cell lymphoma, 7.5% had lung/pleural disease. This organ was the primary site in only 0.7%, while a secondary involvement was registered in 6.8%. Most of them were affected by diffuse large B cell lymphoma (DLBCL; 29/368, 8%) followed by follicular lymphoma (7/188, 4%), mantle cell lymphoma (7/57, 12%), mucosa-associated tissue lymphoma (10/37, 27%), posttransplant lymphoproliferative disease (6/24, 25%), Burkitt lymphoma (3/19, 16%), other lymphomas (1/32, 3%) and Richter transformation (1/11, 9%). Moreover, primary lung/pleural lymphoma is one of the rarest neoplasias affecting the lung, accounting for only 0.4% of cases. Lung/pleural involvement is a very rare condition among B cell lymphomas since it mainly occurs in the setting of a generalized disease. A large majority of patients with secondary organ involvement are affected by DLBCL and have similar clinical features at diagnosis to others with advanced-stage disease.
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Affiliation(s)
- Michael Mian
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
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37
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Catteeuw J, Koegelenberg CFN, Bruwer JW, Sissolak G, Schroeter L, Mohamed N, Irusen EM. A 54-year-old man referred with nonresolving pneumonia. Chest 2014; 146:e92-e96. [PMID: 25180750 DOI: 10.1378/chest.13-2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
A 54-year-old man was referred with nonresolving pneumonia. He had been treated for community-acquired pneumonia 6 weeks earlier. He reported grade 2 dyspnea, malaise, and a nonproductive cough. He had also experienced three episodes of minimal hemoptysis but denied weight loss, fever, or any other constitutional symptoms. He was a nonsmoker and was being treated for dyslipidemia.
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Affiliation(s)
- Julie Catteeuw
- Division of Pulmonology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.
| | - Coenraad F N Koegelenberg
- Division of Pulmonology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Johannes W Bruwer
- Division of Pulmonology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Gerhard Sissolak
- Division of Hematology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Leocardea Schroeter
- Department of Medicine, Division of Anatomical Pathology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Nooroudien Mohamed
- Department of Medicine, Division of Anatomical Pathology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Elvis M Irusen
- Division of Pulmonology, Department of Pathology, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
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38
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Cooksley N, Judge DJ, Brown J. Primary pulmonary Hodgkin's lymphoma and a review of the literature since 2006. BMJ Case Rep 2014; 2014:bcr-2014-204020. [PMID: 24711477 DOI: 10.1136/bcr-2014-204020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 28-year-old woman of Laotian origin presented with dry cough, fevers, night sweats and weight loss over the preceding 6 weeks. Radiological investigations revealed large complex cavitary lesions in the middle and lower lobes of the right lung, with no mediastinal lymph node enlargement. Bronchoscopic investigations did not yield a diagnosis. CT-guided fine-needle aspiration raised the possibility of Langerhans cell histiocytosis. Open lung biopsy initially supported this, but eventually a microscopic and immunohistochemical diagnosis of Hodgkin's lymphoma was made. The final diagnosis was primary pulmonary Hodgkin's lymphoma. We present a new case as well as a literature review of reported cases published since 2006.
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Affiliation(s)
- Nathania Cooksley
- Department of Thoracic Medicine, Cairns Hospital, Cairns, Queensland, Australia
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