Clinical characteristics, diagnosis, treatment, and prognostic factors of pulmonary mucosa‐associated lymphoid tissue‐derived lymphoma

Abstract

Primary pulmonary mucosa‐associated lymphoid tissue‐derived (MALT) lymphoma is a rare disease with a favorable prognosis. However, its clinical characteristics, diagnosis, treatment, and prognoses remain unclear. We retrospectively analyzed 80 patients with pathologically confirmed MALT lymphoma from 2006 to 2018. The clinical characteristics, diagnosis, treatments, and prognoses of all the 80 patients were recorded. Patients were stratified into surgery and biopsy groups, respectively, to evaluate the role of surgery in the diagnosis and treatment of MALT lymphoma. The prognoses were compared between different clinical characteristics and treatments. Pathological diagnoses were confirmed by surgery, bronchoscopy, and percutaneous biopsy. Thirty patients were treated by surgery. While MALT lymphoma was only diagnosed by bronchofiberoscopy or bercutaneous biopsy in four of 18 patients in the surgery group who underwent the procedure. Six patients received adjuvant chemotherapy and one patient received involved‐field radiotherapy in surgery group. Thirty‐one patients were treated with chemotherapy alone, one patient was treated with radiotherapy, one patient received only symptomatic and supportive treatment, and waiting and watching without treatment were recommended in 17 patients in biopsy group. Eight patients died during follow‐up and the 5‐year survival rate was 87.1%. Tumor number, treatment, and age were prognostic factors for overall survival (OS), but age was the only independent prognostic factor according to multivariate analysis. While, tumor number was the only prognostic factor in the analysis about progression‐free survival (PFS). No significant difference was found in OS or PFS between patients treated with and without surgical resection. MALT lymphoma is an indolent disease with favorable treatment outcome. Tumor number is associated with PFS and age is the only significant prognostic factor for pulmonary MALT lymphoma patients because of its indolent nature, but surgery still plays an important role in the diagnosis and treatment of MALT lymphoma.

Treatment and prognosis of primary pulmonary lymphoma: A long‐term follow‐up study

“…For MALT‐PPL and other indolent PPL, therapeutic options are surgery, chemotherapy, immuno‐chemotherapy, immunotherapy, radiotherapy, or "wait and watch" 19 . Although localized therapy (complete surgical resection or radiotherapy) may be associated with improved PFS compared to systemic therapy, no significant difference in OS has been observed 3,20 …”

Asymptomatic Patient with “Lumpy and Bumpy” Airways. A Case of Pulmonary MALToma

“…Most of the patients are asymptomatic at diagnosis. Symptoms, when present, can be non-specific [1]. Radiological findings are also non-specific.…”

“…It may not cause any symptoms and may be detected inadvertently when the patient is being evaluated for some other disease. Radiological findings are also non-specific [1]. We report a case of a 62-year-old male referred to us for preoperative assessment for benign prostatic hyperplasia (BPH), who, upon evaluation, was detected to have pulmonary MALToma.…”

Active surveillance of primary extranodal marginal zone lymphoma of bronchus-associated lymphoid tissue

“…Primary BALT lymphoma was defined as disease confined to the lungs and hilar and mediastinal lymph nodes. 3,4 Patients younger than age 18 years with evidence of other sites of extranodal disease or with lymphadenopathy outside the hilar and mediastinal regions (raising the possibility of nodal or extranodal MZL with secondary lung involvement) were excluded, 7 as were patients with concurrent malignancy, including other lymphoid histology.…”

“…Data about the disease course of BALT lymphoma comes from a few limited retrospective series assessing active interventions [3][4][5][6][7] that demonstrated patients have an excellent overall prognosis. [3][4][5] Equal or superior progression-free survival (PFS) but not overall survival (OS) was found when disease was fully resected compared with disease that was partially resected or treated with systemic chemotherapy or immunotherapy. In other indolent lymphomas, large series have assessed the implementation of active surveillance strategies, demonstrating no OS benefit for systemic interventions.…”