Pulmonary Lymphoma Misdiagnosed as Pneumonia

Lee, Jungsil; Park, Hyunkyung; Kim, Yeon Wook; Yoo, Chul‐Gyu

doi:10.1007/s12288-016-0702-y

Cited by 7 publications

(9 citation statements)

References 2 publications

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“…This type of PPL often accompanied with sign of air bronchogram, and bronchiectatic changes in our study and previously reported ( 6 , 9 , 14 ). Additionally, anti-inflammatory treatment is ineffective to PPL.…”

Section: Resultssupporting

confidence: 87%

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

Xie¹,

Zhang²,

Wu³

et al. 2020

Transl Cancer Res TCR

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Background: The retrospective study was mainly performed to determine the clinical symptoms and radiological characteristics of primary pulmonary lymphoma (PPL) to improve the recognition and diagnosis of the disease.Methods: Between June 2007 and June 2019, the clinical data and radiological images of the 16 patients with PPL confirmed by pathology were retrospectively analyzed.Results: Among the 16 patients with PPL (6 males and 10 females, aged 32 to 72 years, with a median age of 55.13 years), 9 patients were mucosa-associated lymphoid tissue lymphoma (MALT) and 7 patients were diffuse large B-cell lymphoma (DLBCL); all of the patients did not suffer from autoimmune disease [such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or Sjogren's syndrome (SSS)]; and 11 patients had a long-term smoking history from 10 to 40 years. The common clinical symptoms were as follows: chest discomfort (n=8), cough (n=10), chest pain (n=7), fever (n=6), apnea (n=1), fatigue (n=4) and weight loss (n=3), however, 6 cases did not show clear symptoms at the time of diagnosis. Blood tests revealed anemia (n=6), thrombocytopenia (n=2), lactate dehydrogenase (LDH) level (n=7), C-reactive protein (CRP) (n=9), erythrocyte sedimentation rate (ESR) (n=8) and no tumor-related indexes were detected abnormal.The chest radiological images showed a total of 8 cases with multiple masses, 2 cases with different types of nodes, 4 cases with patchy infiltration or consolidation shadow, with or without an air bronchogram, and 2 cases with a mixed manifestation. All the lesions were only involved in unilateral lung (13 right, 3 left), none of them located on bilateral lung fields. At the time of admission, the patients were misdiagnosed as lung cancer (n=9), pneumonia (n=5), tuberculosis (n=1), and diffuse interstitial lung disease (n=1). Then final pathological diagnosis was confirmed by surgery (n=9), percutaneous lung biopsy (n=5), and bronchoscopic biopsy (n=2).Conclusions: PPL is a rare disease, though clinical symptoms and radiological characteristics are not typical, they serve as significant clues for the diagnosis and differential diagnosis. Accurate diagnosis mainly depends on histopathological examination, however, conducting a retrospectively study could improve and enrich our knowledge to the disease and reduce inappropriate treatments.

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Section: Resultssupporting

confidence: 87%

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

Xie¹,

Zhang²,

Wu³

et al. 2020

Transl Cancer Res TCR

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“…We identified 4 types of MALToma lesions, and the nodular ones were the most common (44.44%). This finding is in contrast with previous reports showing that the most frequent presentation was the consolidated type or diffuse interstitial lung disease 9,12,20–23 . Moreover, 3 of the 8 nodular lesions in our study were GGNs, rarely reported before.…”

Section: Discussioncontrasting

confidence: 99%

With the Increasing Health Awareness: Clinical and Computed Tomography Findings in Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma Lymphoma

Xie

Dong

Zhang

et al. 2022

J Comput Assist Tomogr

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Objective:The objective of this study is to investigate the clinical manifestations, computed tomography (CT) findings, and prognosis of primary pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma) with the improved health awareness nowadays.Methods: Clinical data and CT images of patients with pathologically confirmed MALToma from October 2012 to October 2021 were retrospectively analyzed.Results: Eighteen MALToma patients were included in the study (8 men and 10 women; mean age, 56.17 years; range, 33-73 years). Six men had a long-term history of smoking (>20 years). One patient had an autoimmune disease (Sjögren syndrome). Eight patients (44.44%) were asymptomatic, and 10 (55.56%) had mild chest or systemic symptoms. Most lesions (88.89%) were subpleural or located along the bronchovascular tree. According to the CT characteristics, the lesions were divided into 4 groups: nodular type (n = 8; 44.44%, including 5 solid nodules and 3 ground-glass nodules), mass type (n = 4, 22.22%), patch or consolidate type (n = 5, 27.78%), and mixed type (n = 1, 5.56%). Air bronchogram (11/18, 61.11%) and angiogram sign (8/16, 50%) were the most frequent CT findings and may help differential diagnosis. The patients were misdiagnosed with lung cancer (n = 11, 61.11%), inflammatory or chronic inflammatory disease (n = 4, 22.22%), bronchiectasis accompanied by infection (n = 1, 5.56%), diffuse interstitial lung disease (n = 1, 5.56%), and granuloma or tuberculosis (n = 1, 5.56%). The prognosis of all patients was favorable; 1 patient was lost to follow-up.Conclusions: Nowadays, patients with MALToma are usually asymptomatic or paucisymptomatic. Nodular lesions, including ground-glass nodules, are the most common presentation. Mucosa-associated lymphoid tissue lymphoma is most likely misdiagnosed as lung cancer. Lesions located in the subpleural areas or along the bronchovascular tree and presenting with an air bronchogram or angiogram sign could indicate a MALToma diagnosis.

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“…As illustrated by this case, the diagnosis of PPL rests on pathologic findings, thus further emphasizing the importance of prompt transbronchial or transthoracic needle biopsy in suspected cases. Immunohistochemical analysis contributes to the differential and positive diagnosis of MALT-type PPL [9]. The interval between the first clinical or radiological manifestation and diagnosis ranges from 5 months to 8 years.…”

Section: Discussionmentioning

confidence: 99%

Primary pulmonary lymphoma presenting as nodules and masses: a case report and literature review

Gao

Peng

2021

Monaldi Arch Chest Dis

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Primary pulmonary lymphoma (PPL) is a rare neoplasm. We report a case of 45-year-old men who was admitted to hospital for multiple nodules and masses in both lungs. The contrast enhanced chest CT scans revealed multiple nodules and masses of varying sizes in right upper and middle lobes and both lower lobes. CT-guided percutaneous transthoracic needle biopsy was performed. The diagnosis of PPL was confirmed by histopathological examination and Immunohistochemical staining. PPL should be included in the differential diagnoses in symptomless patients with multiple pulmonary nodules and masses.

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Pulmonary Lymphoma Misdiagnosed as Pneumonia

Cited by 7 publications

References 2 publications

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

With the Increasing Health Awareness: Clinical and Computed Tomography Findings in Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma Lymphoma

Primary pulmonary lymphoma presenting as nodules and masses: a case report and literature review

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