Primary pulmonary lymphoma (PCL) is rare and represents only 0.5-1% of the malignant lung tumour. Pulmonary MALT lymphoma is the most common histological aspect. The pathophysiological mechanism remains poorly known, unlike other locations of MALT lymphoma, no pathogen has so far been associated with the lung localization of the disease. It is characterized by slow evolution and atypical clinical presentation which delays diagnosis. The form «pneumonic» on the imaging allows to evoke the diagnosis while the confirmation is based on the immunohistochemical study which detects the presence of positive CD20 cell. Therapeutic options include surveillance of indolent types of LPP, surgery in localized tumors, chemotherapy in diffuse forms. We report two observations of diagnosed pulmonary MALT lymphoma on a scanno-guided bronchial and pulmonary biopsy.
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of neuroendocrine tumor, presenting with very aggressive behavior and a poor prognosis. The diagnosis is difficult and requires histological confirmation of the neuroendocrine nature by an immunohistochemical study on a biopsy sample. We retrospectively studied a series of 14 patients from the pneumology department of the Mohammed VI University Hospital of Oujda, Morocco, over a period of five years (from April 2017 to March 2021). The average age was 63.41 years (45-80 years). All our patients were male and smokers. The clinical signs were dominated by deterioration in general condition and dyspnea. Bronchoscopy was performed in 92% of patients, with neoplastic stenosis being the main found aspect, in 35% of cases. The histological diagnosis was obtained by bronchoscopy in 50% of cases. In the remaining cases, it was carried by CT-guided transparietal biopsy in 28% of cases, pleural biopsy in 7% of cases, biopsy of a metastatic site in 7% of cases and finally thoracoscopy with pleural biopsy in the remaining 7% of cases. Therapeutically, no patient received surgical treatment and three patients were put on palliative treatment. The positive diagnosis is often late, which makes the prognosis bad and the therapeutic possibilities limited. Hence the importance of strategies for the prevention of tobacco control and early detection in population at risk.
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