A patient with endobronchial BALT lymphoma successfully treated with radiotherapy

Hashemi, S.; Heitbrink, Martin A.; Jiwa, Mehdi; Boersma, Wim

doi:10.1016/j.rmed.2006.11.028

Cited by 14 publications

(17 citation statements)

References 9 publications

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“…Although there is no clear aetiology for BALT lymphoma the relationship between smoking and BALT lymphoma and a possible link with autoimmune conditions supports the current hypothesis that BALT lymphoma develops in a similar way to MALT lymphoma 2 – 4. Our patient had no risk factors for chronic lung inflammation such as a history of M tuberculosis , immunodeficiency, childhood illness with whooping cough, measles or pneumonia or inflammatory diseases—for example, rheumatoid arthritis or Crohn’s disease.…”

Section: Discussionsupporting

confidence: 71%

“…Our patient had no risk factors for chronic lung inflammation such as a history of M tuberculosis , immunodeficiency, childhood illness with whooping cough, measles or pneumonia or inflammatory diseases—for example, rheumatoid arthritis or Crohn’s disease. The patient’s recurrent chest infections were secondary to damage caused by BALT lymphoma which is interesting as the usual presentation of BALT lymphoma is non-specific respiratory complaints such as cough, chest pain or dyspnoea2 or is an incidental radiological finding 5…”

Section: Discussionmentioning

confidence: 96%

“…Chemotherapy is usually used in patients who have BALT lymphomas affecting both lungs or multiple sights unilaterally. Radiotherapy is uncommonly used, although case reports do demonstrate that it may be useful as a primary treatment for multilobe BALT lymphoma 2. Outcomes are excellent, irrespective of treatment type, with approximately 90% 5 year survival 1 , 4 , 5 , 10…”

Section: Discussionmentioning

confidence: 99%

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Bronchial associated lymphoid tissue (BALT) lymphoma presenting as chronic lung sepsis

et al. 2009

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A 58-year-old woman was referred from her general practitioner to the respiratory clinic with a 2 year history of recurrent pulmonary infections, mucus hypersecretion and right lobe consolidation following a severe pneumonic illness in 2006. She had no significant risk factors for respiratory disease. Chest computed tomography showed an air bronchogram and right lower lobe consolidation. On initial routine investigation IgA and IgG were normal; however, a discrete IgM paraprotein band in the mid gamma region was seen on serum electrophoresis. She was referred for haematological investigations. Bone marrow biopsy was positive for monoclonal lymphoplasmocytoid B cells and the patient was diagnosed with Waldenström's macroglobulinaemia. Due to recurrent infections and an unclear diagnosis of the lung process, a right lower lobectomy and wedge resection of the middle lobe was performed. This showed bronchial associated lymphoid tissue lymphoma arising in the marginal zone. She has been well since surgery with no further respiratory infections.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Bronchial associated lymphoid tissue (BALT) lymphoma presenting as chronic lung sepsis

et al. 2009

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“…There are a few case reports on radiotherapy as primary therapy for BALT lymphoma [39]. Although we did not use radiation therapy in any of our patients as first-line treatment, it led to durable complete remissions when given as additional treatment to patients with persistent, residual, or recurrent disease after chemo-or immunotherapy.…”

Section: Discussionmentioning

confidence: 81%

Pulmonary marginal zone lymphoma: A single centre experience and review of the SEER database

Stefanovic

Morgensztern

Fong

et al. 2008

Leukemia & Lymphoma

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Pulmonary marginal zone lymphoma is a rare disease arising from bronchial-associated lymphoid tissue (BALT). There is limited information on clinical presentation, natural history and treatment of this type of lymphoma. We conducted a retrospective review of patients with biopsy-proven BALT lymphoma treated at our institution and patients from the surveillance epidemiology and end results (SEER) database. Twenty-one patients (median age 57) with disease stage IE (n = 10) and IV (n = 11), were treated at our institution. Initial management included observation (n = 4), surgery (n = 5), combination chemotherapy (n = 7), single-agent rituximab (n = 3) and radioimmunotherapy (n = 2). Complete remission was observed in 10, partial remission in 3, stable disease in 7, and disease progression in 1 patient. With a median follow-up of 20 months, Kaplan-Meier estimates for progression-free and overall survival (OS) at 80 months were 90% and 95%, respectively. We identified 326 patients (59% females and 41% males; median age 68 [30 to 85) with BALT lymphoma in the SEER database. Fifty-five per cent had stage IE, 10% stage IIE, 3% stage IIIE, and 22% stage IV disease. After a median follow-up of 35 months, median OS was 112 months, and disease-specific median survival was not reached. At 90 months, disease-specific survival was 85% (CI 77-92) with no significant differences in outcome between patients presenting with different stages. Our single institution experience and review of the SEER database, confirm the indolent features and favourable outcome of this rare disease.

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“…There are a few reports on endobronchial BALT lymphoma in the lobar bronchus with lobar atelectasis and left main bronchus with unilateral hyperlucent left lung, but most of these are the case report findings of a single patient (6, 18, 19). …”

Section: Discussionmentioning

confidence: 99%

Primary Endobronchial Marginal Zone B-Cell Lymphoma of Bronchus-Associated Lymphoid Tissue: CT Findings in 7 Patients

et al. 2013

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ObjectiveTo investigate CT and 18F-flurodeoxyglucose (18F-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT).Materials and MethodsFrom June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 18F-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening.ResultsA solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n = 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 18F-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake.ConclusionPrimary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 18F-FDG-PET/CT.

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A patient with endobronchial BALT lymphoma successfully treated with radiotherapy

Cited by 14 publications

References 9 publications

Bronchial associated lymphoid tissue (BALT) lymphoma presenting as chronic lung sepsis

Bronchial associated lymphoid tissue (BALT) lymphoma presenting as chronic lung sepsis

Pulmonary marginal zone lymphoma: A single centre experience and review of the SEER database

Primary Endobronchial Marginal Zone B-Cell Lymphoma of Bronchus-Associated Lymphoid Tissue: CT Findings in 7 Patients

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