A Rare Case of Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma Transforming into Diffuse Large B-Cell Lymphoma

Abstract

Mucosa-associated lymphoid tissue lymphoma (MALToma) is a low grade B-cell lymphoma that develops from the lungs, intestinal tract, salivary gland, and other organs and is included under extranodal marginal zone lymphoma. When a primary pulmonary MALToma develops from bronchus-associated lymphoid tissue (BALT), it is called BALT lymphoma (BALToma). The etiology of MALToma is not clear; however, an association between chronic inflammatory conditions and BALToma has been observed. Transformation of MALToma to high grade lymphoma is very rare. We experienced a case of MALToma that had developed from the lungs in a patient who was undergoing treatment for latent tuberculosis and rapidly transformed into high grade B-cell lymphoma.

Synchronous pulmonary MALT lymphoma and squamous cell lung cancer: a case report

“…The most common type of PPL is MALT lymphoma of bronchial origin, which accounts for 70–90% of all PPLs [ 9 ]. The disease lacks specificity in clinical presentation, has diverse imaging features, and has a high rate of missed diagnoses and misdiagnoses [ 3 ]. At present, most scholars believe that the tumorigenesis of MALT lymphoma is initiated by long-term exposure to a variety of antigens (such as smoking, infection, autoimmune diseases), which is a defensive response [ 10 , 11 ].…”

“…Pulmonary MALT lymphoma, a rare tumor originating from bronchial mucosa-associated lymphoid tissue, is the major histologic type of primary pulmonary lymphoma, with an incidence of 0.5% of primary lung tumors [ 2 ]. Pulmonary MALT lymphoma is not characterized by clinical manifestations due to low incidence, slow progression, and extremely easy to be missed or misdiagnosed [ 3 ].…”

Rare Primary Pulmonary Marginal Zone Lymphoma Presenting with Incidental Pulmonary Nodules

“…This unique translocation is responsible for the creation of a fusion RNA transcript from the API2 (apoptosis inhibitor 2) and the MALT1 genes which induces activation of the NF- κ B pathway resulting in cell proliferation [8, 9]. Unlike gastric MALT lymphoma which is associated with Helicobacter pylori , MALT lymphoma of the lung has not been linked to any infectious or specific autoimmune conditions, although there have been case reports associated with tuberculosis [10]. Like gastric MALT lymphoma, it is postulated that pulmonary MALT lymphoma can progress to high-grade diffuse large B-cell lymphoma (DLBCL); however, this has not been well studied [1].…”

A case report of unusual cavity presentation of pulmonary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue

“…Bae et al classified the pattern of parenchymal lesions into the following 4 different patterns including: single-nodular or consolidative; multiple nodular or areas of consolidation; bronchiectasis and bronchiolitis; and DILD. [ 7 , 8 ] But the cavity presentation has not yet been described. We are wondering whether it is a new pattern which we have ignored.…”

“…The mechanism of the cavity formation in pulmonary MZBL of MALT type remains unknown, but it is thought to be due to a check-valve mechanism like the other lung cancer. [ 8 ] Another reason could be a result of avascular necrosis and destruction of the pulmonary alveoli by excessive mucus. [ 9 ] Furthermore, we hypothesize repeated infection might be one of the reasons.…”