Primary lung lymphoma involving the superior vena cava

Abstract

Primary lung lymphoma (PLL) presenting as a primary pulmonary lesion is rare and usually affects elderly people. Here we describe a 25-year-old Chinese man diagnosed with primary lung lymphoma, which presented as a huge lung tumor mimicking a primary lung cancer and involving the superior vena cava. He underwent double-sleeve reconstructions of bronchus and pulmonary arteries with right upper- and middle-lobe lobectomy along with replacement of the superior vena cava with a graft, and was then given standard chemotherapy of CHOP plus Rituximab. The patient has been well, showing no local recurrence or distal metastasis during a 27-month follow-up.

Primary Pulmonary Diffuse Large B-Cell Lymphoma on FDG PET/CT-MRI and DWI

“…Large B-cell lymphoma, usually progress rapidly, is frequently treated by CHOP, and rituximab may improve the response to CHOP treatment. The median time to disease recurrence or death in this series is 6 years, 6 and patients who did have disease recurrence were all successfully treated with chemotherapy. In our case, rituximab–CHOP treatment had been proved efficacious.…”

“…The incidence of PPL peaks in the 5th and 7th decades of life, with a male-to-female ratio of 1.07:1. 6 Most PPLs patients present with nonspecific symptoms, such as dry cough or chest pain. High lactic dehydrogenase levels, high sedimentation rates, and anemia are typical.…”

Diagnosis of primary pulmonary T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia via clinicopathological observation and molecular assay

“…Thus, in addition to the pathological manifestations of bronchial mucosal biopsy and surgical biopsy, abnormal chest radiography and CT images may also be of value for diagnosis. Recently, increased numbers of disuse large B-cell lymphoma (DLBCL) cases with various manifestations have been reported, which could be misdiagnosed as TB [ 9 ] or lung cancer [ 10 ]. A long-term follow-up study of PPL-DLBCL, the largest known series thus far, noted strong homogeneity among the patients: low clinical risk, early stage, and no bulky tumor mass, normal lactic dehydrogenase and beta 2 microglobulin [ 11 ].…”

“…In general, there is no clear classification of DLBCL encountered in pulmonary systems. In fact, PLL-DLBCL has been reported only in case reports [ 9 , 10 ], most subtypes of them are centroblastic or immunoblastic variants, as elsewhere, which are the more common morphological variants of DLBCL [ 1 , 11 , 16 , 17 ]. In addition, some rare types of DLBCL, such as the anaplastic variant, were also reported [ 18 ].…”

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

“…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)(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).…”