Linfoma do tecido linfóide associado ao brônquio com evolução fatal

Abstract

Primary pulmonary lymphoma is rare. The most common histological type is the bronchus-associated lymphoid tissue lymphoma. This type of lymphoma has an indolent course and excellent response to therapy. One-third of all cases are diagnosed incidentally. However, due to the rarity of this disease, little is known about its natural history in terms of dissemination and evolution. Herein, we report the unusual case of a 61-year-old man who refused treatment after being diagnosed with bronchus-associated lymphoid tissue lymphoma and died 2 years later from massive lung infiltration without dissemination to other organs.Keywords: Lung; Autopsy; Lymphoma. ResumoLinfomas primários do pulmão são raros. O tipo histológico mais freqüente é o linfoma do tecido linfóide associado ao brônquio. Este tipo de linfoma tem curso indolente e excelente resposta à terapia. Um terço dos casos é descoberto incidentalmente. Devido à raridade desta doença, no entanto, pouco se conhece sobre sua história natural em termos de disseminação e evolução. Neste relato, descrevemos o caso incomum de um homem de 61 anos que recusou o tratamento após diagnóstico de linfoma do tecido linfóide associado ao brônquio e, 2 anos após o diagnóstico, morreu por infiltração pulmonar maciça sem disseminação para outros órgãos.

Primary pulmonary mucosa-associated lymphoid tissue lymphoma computed tomography findings: a case report

“…However, it is characteristic that the lesions remain restricted to the lungs for long periods of time before dissemination. The interval between the first clinical or radiological manifestation and diagnosis ranges from 5 months to 8 years, which reflects the indolent course of this disease [1,7]. …”

“…When located in the lung, this lymphoma appears to arise from preexistent resident bronchus-associated lymphoid tissue (BALT) and is thought to be acquired as a result of chronic antigenic stimulation such as smoking, autoimmune diseases, or infections [1,6,7,9-11]. In fact, before the development of more accurate immunohistochemical techniques and molecular biology-based method, most cases were classified as pseudo-lymphomas, a benign inflammatory lymphocytic infiltrate [1,7].…”

“…In fact, before the development of more accurate immunohistochemical techniques and molecular biology-based method, most cases were classified as pseudo-lymphomas, a benign inflammatory lymphocytic infiltrate [1,7]. …”

“…The majority of studies reports that the two genders are equally affected [1,7], although a female predominance has been suggested [1]. They infiltrate the pulmonary interstitium, often massively, and may form nodular aggregates and extend into the air spaces [10].…”

“…Several treatment options are available, including tumor resection, radiotherapy, surgery with adjuvant chemotherapy or chemotherapy alone. The treatment remains controversial but the prognosis is excellent [5-7,9]. …”