Lymphoproliferative lung disorders: clinicopathological aspects

Abstract

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

Rare Case of Nodular Lymphoid Hyperplasia of Left Lung in the Patient With Previous Pulmonary Tuberculosis

“…There are three main rare forms of benign pulmonary lymphoid hyperplasia, namely: follicular bronchiolitis, pulmonary NLH and lymphocytic interstitial pneumonia [4][5][6][7][8]. The characteristic morphological feature of NLH is the presence of one or more pulmonary nodules with manifestation of lymphoid tissue proliferation with reactive germinal centers and preserved mantle zones.…”

“…Thus, thanks to modern immunohistochemical and molecular genetic methods of pathomorphological diagnosis, NLH is identified as a separate nosological form [1,9,12]. Recent studies indicate that pulmonary NLH may belong within the family of IgG4-related sclerosing diseases [4,7,13,14].…”

Therapy features of interstitial lymphocytic lung disease (ILLD) in patients with immune dysregulation syndromes: case report

“…ИЛБЛ развивается за счет патологической фолликулярной гиперплазии бронхо-ассоциированной лимфоидной ткани или диффузного инфильтративного повреждения интерстиция [23] и имеет четко очерченную гистологическую характеристику. Она может быть представлена тремя патоморфологическими формами: фолликулярный бронхиолит (ФБ), нодулярная лимфоидная гиперплазия (НЛГ) и лимфоцитарная интерстициальная пневмония (ЛИП), но часто наблюдается смешанный вариант [24].…”

Lymphoid Interstitial Pneumonia and Other Benign Lymphoid Disorders

“…Benign pulmonary lymphoid disorders include a wide spectrum of focal or diffuse abnormalities distinguished on the basis of histological examination, cellular morphology, and clonality. [3][4][5][6][7] They are characterized by a polyclonal lymphoid infiltrate with differing patterns and distribution. Lymph nodes, airways, interstitium, or localized areas within the lung parenchyma can be involved.…”