Pulmonary carcinoid tumors: Experience from an oncology center

Abstract

Background: Primary pulmonary non-Hodgkin's lymphoma(NHL) is very rare, and although the prognosis is favorable, clinical features, beneficial diagnostic procedures, prognostic factors and optimal management have not been clearly defined. Methods: In this study, thirty-eight cases of primary pulmonary NHL treated in Shanghai Chest Hospital during a 10-year period were retrospectively reviewed, and clinicopathological features and prognosis were analyzed. Results: There were twenty-eight patients with mucosa-associated lymphoid tissue (MALT) lymphoma, three with diffuse large B-cell lymphoma, one with peripheral Tcell lymphoma, one with mantle cell lymphoma and five with unclassified B-cell lymphoma. The cohort consisted of 21 male and 17 female patients with a median age of 57.5 years. At presentation, 36.8% of patients were asymptomatic, and unilateral tumors occurred more frequently than bilateral and predominantly in the right lung. Thirtythree patients underwent surgical resection single or combination chemotherapy, and five patients received combination chemotherapy alone. Overall survival(OS) was significantly longer in patients with MALT lymphoma than that of non-MALT lymphoma (129.9 vs. 71.5 months, P ¼ 0.019 by log-rank test). Patients who had received surgical resection had a better OS (126 vs. 65.4 months, P ¼ 0.036 by log-rank test). Additionally, multivariate analysis showed that elevated serum lactate dehydrogenase (LDH) level was independently associated with a poor OS (P ¼ 0.048). Conclusions: Primary pulmonary NHL has atypical clinical manifestations and nonspecific imaging changes. Surgical resection is vital in clarifying the diagnosis and obtaining a favorable prognosis. Serum LDH level was an independent prognostic factor.