Primary pulmonary non-Hodgkin’s lymphoma: ten cases with a review of the literature

Abstract

Bulgular:Hastaların sekizi erkek ikisi kadın olup, ortanca yaş 50 (aralık 29-76) Lymphomas, which are malignant tumors of lymphoid tissue, may rarely be detected as a form of primary lung disease, although they usually affect the lungs secondarily through hematogenous dissemination or direct invasion from hilar/mediastinal lymph nodes. Primary pulmonary lymphomas (PPL) represent < 1% of primary malignant lung tumors, < 1% of lymphomas and only 3-4% of extranodal lymphomas (1-3).PPLs originate from mucosa-associated lymphoid tissue (MALT) (4). These tumors may be a type of Hodgkin's or non-Hodgkin's lymphoma (NHL). The majority of PPLs consists of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and diffuse large B-cell lymphomas (DLBCL), which are types of NHLs (5).Pulmonary MALT lymphoma usually has an indolent course, remaining localized to the lung for long periods before dissemination. However, DLBCL is less frequent and is believed to have a poorer prognosis than MALT lymphoma (6,7).Although some studies have reported this rare disease, the histopathological features, clinical course, optimal treatment, role of surgery, and prognostic factors are not well defined (8)(9)(10)(11)(12). In this study, we assessed the clinical, radiological, diagnostic, and pathological features of our cases with primary pulmonary non-Hodgkin's lymphoma (PPNHL), along with prognosis and treatment results. MATERIALS and METHODSOur clinical (surgery clinic) database records were reviewed retrospectively, as we attempted to find patients with a diagnosis of PPNHL between January 2004 and February 2009. As this was a retrospective study, ethics committee acceptance not needed. Scientific Study Committee of our hospital reviewed and approved the database. We used the following criteria to diagnose PPNHL (10,13): Information on demographic variables, clinical and radiological findings, medical history, the procedures applied to patients to diagnose and treat, and histopathological findings of the tumors was gathered through the clinical database and patient files.

Primary pulmonary Hodgkin's lymphoma and a review of the literature since 2006

“…These tumours may be a type of Hodgkin's (PPHL) or non-Hodgkin's lymphoma (NHL) 8. Primary pulmonary lymphomas are rare entities,9 and of these, only 1.5–2.4% are attributable to PPHL 10…”

A Case of Primary Pulmonary Diffuse Large B-Cell Lymphoma Diagnosed by Transbronchial Biopsy

“…3) Bronchoscopy is thought to be of limited value, as for diagnosis of PPL because endobronchial changes in PPL are rare. 3,9) However, in the present case, our diagnosis was made via bronchoscopy. Therefore, even if malignant lymphoma is suspected on images, bronchoscopy may be effective.…”

“…Although less frequent, DLBCL is believed to have a poorer prognosis than MALT lymphoma. 3) The radiological aspect (in 50%-90% of PPL cases) is a localized alveolar opacity, with a diameter of <5 cm and blurred or well-defined contours (according to the series); PPL is associated in nearly 50% of cases with an air bronchogram, 6) and peribronchial disease, proximal bronchiectasis, and positive CT-angiogram signs are ancillary features. 7) In the present case, radiography showed a nodular opacity with regular margins, which can be considered atypical.…”

“…2) PPLs represent <1% of primary malignant lung tumors, <1% of lymphomas, and only 3%-4% of extranodal lymphomas. 3) A commonly used set of criteria for PPL proposed by L'Hoste and associates is lymphoma with involvement of the lung, lober, or primary bronchus, with or without mediastinal involvement, and no evidence of extrathoracic lymphoma at the time of diagnosis or for 3 months thereafter. 4,5) The most common PPL type is mucosa-associated lymphoid tissue (MALT) lymphoma, an extranodal marginal zone lymphoma that accounts for 80%-90% of PPL cases.…”

Comparisons of Surgery and/or Chemotherapy in the Treatment of Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma

“…Primary pulmonary lymphoma is very rare, and the most common histological type of MALT is the bronchial extranodal marginal zone B-cell lymphoma with a long disease course, slow disease progression, few systemic symptoms, and a low incidence rate. 2) In this study, the median age of onset was 59 years, and the age ranged from 21 to 67 years. There were nine patients over 50 years of age that accounted for 69% of the patients.…”