Clonality analysis of alveolar B lymphocytes contributes to the diagnostic strategy in clinical suspicion of pulmonary lymphoma

Zompì, Simona; Couderc, Louis‐Jean; Cadranel, Jacques; Antoine, Martine; Epardeau, B; Fleury‐Feith, Jocelyne; Popa, Natalia; Santoli, François; Farcet, Jean‐Pierre; Delfau‐Larue, Marie‐Hélène

doi:10.1182/blood-2003-07-2335

Cited by 60 publications

(31 citation statements)

References 39 publications

(33 reference statements)

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“…Screening for monoclonal IgG in BALF supernatant (via immunoelectrophoresis) and restricted membranous or intracytoplasmic Ig light-chain expression (via slide immunohistochemistry) may be useful for diagnosis. 11 The absence of a dominant B-cell clone in BALF could help dismiss invasive investigations of pulmonary lesions. In our patient, BALF was inconclusive.…”

Section: Discussionmentioning

confidence: 99%

Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma in a Patient With Acquired Immune Deficiency Syndrome

Verma¹,

Jain

Singhal

et al. 2011

Respir Care

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Section: Discussionmentioning

confidence: 99%

Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma in a Patient With Acquired Immune Deficiency Syndrome

Verma¹,

Jain

Singhal

et al. 2011

Respir Care

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“…Flow cytometry and immunocytochemical analysis could reveal a monotypic expression of surface light chains (indicating a clonal B-cell proliferation). Recent studies report that genotyping investigation on BAL fluid can contribute to the diagnosis of MALT lymphoma with an even higher sensitivity and sensibility [59]. In different lymphomas, BAL is less sensitive and specific; infrequently, Reed-Sternberg/Hodgkin cells may also be detected.…”

Section: Diagnosis and Staging Of Lymphoproliferative Lung Disordersmentioning

confidence: 99%

“…Neoplastic lymphocytes are characterised by distinct molecular profiles useful to distinguish pulmonary MALT lymphoma from reactive processes and other lymphomas. [59]. Flow cytometry can provide relevant information by revealing the presence of clonal B-cell populations characterised by immunoglobulin light chain restriction, as well as illustrating an antigenic profile compatible with the diagnosis.…”

Section: Diagnosis and Staging Of Lymphoproliferative Lung Disordersmentioning

confidence: 99%

Lymphoproliferative lung disorders: clinicopathological aspects

Poletti¹,

Ravaglia²,

Tomassetti³

et al. 2013

European Respiratory Review

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Lymphoproliferative disorders are rarely observed as primary lesions in the lung, representing only 0.3% of all primary pulmonary malignancies, ,1% of all the cases of non-Hodgkin lymphoma and 3-4% of all the extra nodal manifestations of non-Hodgkin lymphoma. The earliest comprehensive studies of pulmonary lymphomas were those of SALTZSTEIN [1] and PAPIOANNOU and WATSON [2], which were published in the 1960s. These investigators made important observations: low-grade neoplasms were more frequent than higher grade lymphomas (reticulum cell sarcomas) and both tumours had better clinical outcomes than their nodal-based counterparts. The authors also concluded that the majority of neoplasms with a low-grade cytological appearance should be considered as reactive proliferations, introducing the term ''pseudolymphoma''. This hypothesis showed significant weak points and, approximately 20 years later, ADDIS et al. [3] concluded that ''most if not all the cases of pseudo-lymphoma can be classified, when re-evaluated, as malignant lymphoma''. Knowledge of these entities expanded rapidly after the advent of new investigative tools such as immunohistochemistry and molecular biology techniques. The World Health Organization (WHO) classification of lymphoid neoplasm recently emphasised the importance of clinical features [4]. Table 1 provides an overall classification of lymphoproliferative disorders, which are described as: reactive/nonneoplastic lymphoid lesions, malignant parenchymal lymphoproliferative lesions (primary or secondary) and post-transplant lymphoproliferative disorders. Pathological aspectsReactive pulmonary lymphoid diseases Three rare forms of benign hyperplasia of pulmonary lymphoid tissue, namely follicular bronchiolitis, pulmonary nodular lymphoid hyperplasia and lymphocytic interstitial pneumonia, are regarded as part of the spectrum of lymphoid hyperplasia of the bronchus-associated lymphoid tissue (table 1) [5,6]. Follicular bronchiolitis is characterised by lymphoid follicular hyperplasia, often with reactive germinal centres, in the walls of bronchioles with narrowing of the lumen. Pulmonary nodular lymphoid hyperplasia (pulmonary pseudo-lymphoma) is a distinct form of reactive lymphoid proliferation with links to the family of IgG4-related sclerosing diseases, characterised by a dense nodular infiltration of mature, polyclonal lymphocytes and plasma cells, which are well-circumscribed and mainly sub-pleural, with some dense fibrosis between

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“…between primary and secondary pulmonary lymphoma YUHAO 1,3 , JING LIU 1,3 , CHANGHONG LIANG 1 and SHUIXING ZHANG manifestations with variant imaging features (8,9). Standard treatment protocols for PPL remain under investigation and are typically based on expert opinion rather than evidence-based, while therapy for SPL varies from its primary lesions (2).…”

Section: Significance Of Imaging and Clinical Features In The Differementioning

confidence: 99%

“…The most common type of PPL is mucosa-associated lymphoid tissue (MALT) lymphoma (70-90%), with the remainder comprising a miscellaneous group that includes non-Hodgkin low-grade extra-nodal B-cell lymphoma (NHL-B), high-grade diffuse large B-cell lymphoma (DLBCL) (5-20%), primary pulmonary Hodgkin's lymphoma and certain other extremely rare diseases (5)(6)(7). Secondary pulmonary lymphoma (SPL), which is more common than PPL, refers to a secondary involvement of the lung from a known extra-pulmonary lymphoma or dominant pulmonary lesion, with indolent primary extra-pulmonary lesions observed within 3 months (8).…”

Section: Introductionmentioning

confidence: 99%

Significance of imaging and clinical features in the differentiation between primary and secondary pulmonary lymphoma

et al. 2017

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Abstract. The aim of the present study was to analyze the differences in imaging and clinical features between primary pulmonary lymphoma (PPL) and secondary pulmonary lymphoma (SPL) to provide insight into pulmonary lymphoma for an improved clinical diagnosis. A retrospective study of 38 patients with pulmonary lymphoma (19 PPL and 19 SPL) treated between September 1, 2006, and December 31, 2015, was performed. The clinical manifestations, and computed tomography (CT) and positron emission tomography-CT images of each case were collected. χ 2 and Fisher's exact tests were applied to assess statistically significant differences between PPL and SPL in terms of clinical and imaging features. The significant variables were further applied to canonical discriminate analysis. The CT results revealed that the occurrence of a >3-cm mass (P=0.007), peripheral location (lower than the segmental bronchi) (P=0.027), cavitation (P=0.008) and consolidation (P=0.027) were associated with PPL, while peripheral and hilar location (P=0.003) or mediastinal and hilar lymph node engagement (P=0.044) were predominantly observed in SPL. However, no significant differences between clinical manifestations and the maximum standard uptake value of pulmonary lesions in PPL and SPL were identified (all P>0.05). A function derived from discriminate analysis was generated that may predict the affiliation to PPL or SPL radiographically, with an overall accuracy of ≤92.1%. The results of the present study revealed that PPL and SPL exhibit distinctive features on CT images due to distinct molecular mechanisms and growth patterns. Careful observation of CT features may be useful in the diagnosis of PPL and SPL regarding the tumor morphology, location and lymph node involvement. IntroductionPulmonary lymphomas may occur as a primary pulmonary malignancy or a secondary manifestation derived from systemic lymphoma (1). Primary pulmonary lymphomas (PPLs) are defined as malignant lymphomas originating from pulmonary parenchyma or bronchi with or without hilar lymph node involvement, in the absence of tumor dissemination for ≥3 months after the diagnosis (2,3). Prevalence ranges between 0.5 and 1% of PPL malignancies and accounts for <1% of malignant lymphomas (4). The rarity of PPL may be attributed to pulmonary tissue containing less lymphoid tissue compared with other sites. The most common type of PPL is mucosa-associated lymphoid tissue (MALT) lymphoma (70-90%), with the remainder comprising a miscellaneous group that includes non-Hodgkin low-grade extra-nodal B-cell lymphoma (NHL-B), high-grade diffuse large B-cell lymphoma (DLBCL) (5-20%), primary pulmonary Hodgkin's lymphoma and certain other extremely rare diseases (5-7). Secondary pulmonary lymphoma (SPL), which is more common than PPL, refers to a secondary involvement of the lung from a known extra-pulmonary lymphoma or dominant pulmonary lesion, with indolent primary extra-pulmonary lesions observed within 3 months (8).These two origins of pulmonary lymphoma distinguish themselves patho...

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Clonality analysis of alveolar B lymphocytes contributes to the diagnostic strategy in clinical suspicion of pulmonary lymphoma

Cited by 60 publications

References 39 publications

Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma in a Patient With Acquired Immune Deficiency Syndrome

Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma in a Patient With Acquired Immune Deficiency Syndrome

Lymphoproliferative lung disorders: clinicopathological aspects

Significance of imaging and clinical features in the differentiation between primary and secondary pulmonary lymphoma

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