Early involvement of the bronchi in patients with malignant lymphoma

Abstract

Fibreoptic bronchoscopy in previously untreated patients with malignant lymphoma provided diagnostic information in 8 of 25 cases with radiological evidence of intrathoracic involvement. There was a marked difference in the pattern of endobronchial involvement between Hodgkin's Disease (HD) and Non Hodgkin's Lymphoma (NHL) which specifically infiltrated the bronchus-associated lymphoid tissue. Bronchoalveolar lavage was abnormal in only one patient with Hodgkin's Disease in whom the presence of many Sternberg-Reed cells suggested occult dissemination of otherwise localised disease. Images Figure 1 Figure 2

Endobronchial Hodgkin's Lymphoma

“…It is also not established whether there is any particular histological pattern associated with endobronchial HD [4]. In a review of 30 cases, no clear histological pattern was found [1,2,4,7,10,14]. Both our cases were of the nodular sclerosing type.…”

“…The pathogenesis of endobronchial lymphomas remains unclear. The disease may arise from mucosal lymphoid tissue, or spread contagiously from hilar lymph nodes or through hematogenous spread [4][5][6][10][11][12][13]. If there is associated proximate hilar adenopathy and clear uninvolved bronchial mucosa over the endobronchial lymphoma, the cause of endobronchial lesions is likely to be due to transmural spread [10].…”

Endobronchial presentation of Hodgkin's disease: a report of nine cases and review of the literature

“…Based on autopsy data, the incidence of intrabronchial involvement in cases of established Hodgkin's disease may be as high as 15%, but most frequently develops during the disease. Initial endobronchial involvement is very rare; only 34 cases, which fulfilled our inclusion criteria, were found in the literature [9][10][11][12][13][14][15][16]. However, many of these were published a long time ago, and precise data are lacking.…”

“…The incidence of endobronchial presentation of Hodgkin's disease is difficult to state, but could be more frequent than previously thought. In a small series of patients who underwent systematic fibreoptic bronchoscopy during initial staging, 3 of 12 cases had pathologically proven endobronchial lymphoma [11]. In our study, bronchoscopy was not performed in a systematic prospective fashion but only when respiratory symptoms or bulky mediastinum was present.…”

A Case of Adult T Cell Leukemia/Lymphoma Presenting as Severe Tracheal Stenosis

“…Related case reports in the 1980s were written without awareness of ATLL since the concept of the disease had only just been established (7)(8)(9)(10). In 1992 Tanigawa et al reported 47 cases of non-Hodgkin's lymphomas with EBI who had been encountered by 1990, but no case of ATLL was included (5).…”