Case Of Primary Pulmonary Lymphoma Research Articles

Unveiling the Unseen: A Rare Case of Primary Pulmonary Lymphoma

Unveiling the Unseen: A Rare Case of Primary Pulmonary Lymphoma

Diagnostic Efficacy of CT Radiomic Features in Pulmonary Invasive Mucinous Adenocarcinoma.

In order to solve the problem of the effect of CT images on the diagnosis of lungs, the authors proposed a method for the diagnosis of invasive mucinous adenocarcinoma of the lungs based on CT radiomic features, and the modified method is found by reviewing past cases: among the 34 cases of primary pulmonary lymphoma, 12 cases were nodular mass type, 19 cases were nonnodular mass type, and 3 cases were mixed type; 13 cases involved bilateral lung lobes, 7 cases involved right lung, and 4 cases involved left lung example. There were 17 cases of tumor consolidation density shadow, 17 cases of mixed density shadow, the average CT value was about 32HU, 15 cases of cavitation sign, 6 cases of cavity, 9 cases of angiography sign, 30 cases of air bronchus sign, 22 cases of bronchiectasis, bronchial stenosis or amputation in 8 cases, pleural effusion in 12 cases, lymph node enlargement in 15 cases, and pleural metastasis in 2 cases. The final pathological results included 24 cases of membrane-associated lymphoid tissue (MALT) lymphoma, 9 cases of diffuse large B-cell lymphoma (DLBCL), and 1 case of T-cell lymphoma. The CT manifestations of primary pulmonary lymphoma (PPL) are diverse and do not have obvious specificity, the imaging manifestations are correlated with pathological types, and air bronchial signs, bronchiectasis, angiography signs, and other signs are used for the diagnosis of PPL. This is of great significance for the diagnosis of PPL.

Clinical Analysis of 50 Cases of Primary Pulmonary Lymphoma: A Retrospective Study and Literature Review.

Objective: This study aimed at to raise the awareness understanding of primary pulmonary lymphoma (PPL) by analyzing the clinical manifestation, imaging, pathology, diagnosis, treatment, and prognostic features of 50 cases of PPL. Methods: The study of 50 individuals with PPL diagnosed at the First affiliated hospital of Nanchang university between January 2009 and December 2019 was performed. Results: Overall, 27 males and 23 females were enrolled, with an average age of 57.6 ± 15.6 years. The primary symptoms included, cough (n = 37), expectoration (n = 25), sputum with blood (n = 12), and chest pain (n = 12). Two individuals had Hodgkin's lymphoma and 48 patients had non-Hodgkin's lymphoma (NHL). We divided the NHL cases into mucosa-associated lymphoid tissue lymphoma (MALT) (n = 21), diffuse large B-cell lymphoma (n = 12), small lymphocytic lymphoma (n = 2), mantle B-cell lymphoma (n = 2), follicular lymphoma (n = 1), B-cell lymphoma without further classification (n = 8), and T-cell lymphoma (n = 2). The imaging findings revealed that unilateral lung involvement was more common among the patients. The longest follow-up duration up to December 2019 was 123 months with 40 surviving patients. The 5-year overall survival and progression-free survival were 46.7% and 44.4%, respectively. Age was an independent predictive factor for the 5-year survival (hazard ratio, 8.900; P = .038), (P < .05). Conclusion: PPL is a uncommon disease with atypical clinical manifestations and is often misdiagnosed. Immunohistochemistry is currently the standard used in pathologic evaluation of PPL. MALT prognosis is better in contrast with other kinds of PPL. Surgery or radiotherapy can be considered in patients with limited lesions, and chemotherapy is the first treatment option for diffuse lesions. Age of ≥ 60 years was reported as an independent adverse predictive factor.

A Case of Primary Pulmonary Lymphoma with Severe Stenosis of the Central Airway

A Case of Primary Pulmonary Lymphoma with Severe Stenosis of the Central Airway

Comparison of radiologic characteristics and pathological presentations of primary pulmonary lymphoma in 22 patients.

ObjectiveThis study was performed to compare the radiologic characteristics and pathological presentations of primary pulmonary lymphoma (PPL), explore the possible mechanism underlying its development, summarize its radiologic characteristics, and improve the accuracy of its diagnosis.MethodsThe medical records of 22 patients pathologically diagnosed with PPL were retrospectively analyzed.ResultsChest computed tomography (CT) demonstrated single or multiple nodules and masses in the lungs, patchy opacities or consolidation along the bronchovascular bundle, and no significantly enlarged mediastinal or hilar lymph nodes. All 22 cases of PPL were classified as non-Hodgkin’s lymphoma (NHL) by transbronchial biopsy, CT-guided needle biopsy, and postoperative pathology. Most (16 cases) were marginal-zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT). Twelve patients had air bronchograms within the lesion, and 13 showed ill-defined lesions with ground-glass brush-like changes.ConclusionPPL is a rare lung tumor, and most are classified as MALT lymphoma, a subtype of NHL. Chest CT can help to diagnose this disease. Positron emission tomography (PET)/CT is of great clinical value for evaluation of the lesion and patient’s general condition. The possibility of PPL should be considered in patients with characteristic CT and PET/CT findings and mild clinical symptoms, and early treatment should be administered.

Primary pulmonary lymphoma: imaging findings in 30 cases.

To present our experience of cases of primary pulmonary lymphoma (PPL) found between January 2002 and July 2018, focusing on the radiological features and the differential diagnosis in order to contribute to the difficult role of the radiologist in the disease identification and to help the clinicians to reach the diagnosis. CT scans of 30 patients (14 men and 16 women, aged 58-86, mean age 72years) with PPL were retrospectively reviewed. All patients had a histopathological confirmation of the disease: MALT lymphoma (23 patients, 76.6%); diffuse large B-cell lymphoma-DLBCL (seven patients, 23.4%). All the staging CT scans were evaluated by three experienced radiologists dedicated to thoracic disease in order to radiologically define the predominant pattern of presentation. The following parenchymal patterns were observed: 11 patients with single/multiple nodules, five with masses/mass-like consolidations, 14 with consolidations with air bronchogram, 16 with ground-glass opacity, ten with angiogram sign, 22 with perilymphatic and/or peribronchovascular spread, 15 with associated lymphadenopathies, and 13 with pleural/chest wall involvement. The main characteristics of PPLs were the presence of consolidations and ground-glass opacities, with perilymphatic and/or bronchovascular spread. All the characteristics of the work should alert the radiologist to consider lymphoma among the possible differential diagnoses, always correlating the results of the CT examination with appropriate clinical laboratory evaluations.

経気管支肺生検にて診断のついた肺原発悪性リンパ腫の 1 例

経気管支肺生検にて診断のついた肺原発悪性リンパ腫の 1 例

Primary pulmonary lymphoma mimicking a refractory lung abscess: A case report.

The current study presents a case of primary pulmonary lymphoma (PPL) mimicking refractory lung abscess that was diagnosed at autopsy. An 80-year-old male with clinically inapparent aspiration presented with a large cavitated mass and pleural effusion. A lung abscess and empyema was diagnosed, therefore, antibiotics were administered and the pleural effusion was drained. Various examinations, including a biopsy, yielded no specific diagnosis. The lesion was considered inoperable due to the poor general condition of the patient. Subsequently, the mass that had been diagnosed as a refractory lung abscess became enlarged and a repeat biopsy resulted in a diagnosis of diffuse large B-cell lymphoma. The patient succumbed to sudden respiratory failure, and the final diagnosis of PPL was confirmed at autopsy. PPL is a rare disease that accounts for 0.45% of all pulmonary malignant tumors and is difficult to diagnose in inoperable cases. Therefore, patients with PPL who do not undergo surgery can be misdiagnosed and consequently treated inappropriately. PPL should therefore be considered in the differential diagnosis of a refractory lung abscess.

A clinical analysis of 40 cases of primary and secondary pulmonary lymphoma

To investigate the clinical manifestations, pathological types, treatment and prognosis of primary pulmonary lymphoma (PPL) and secondary pulmonary lymphoma (SPL). The clinical data of 40 cases of PPL or SPL diagnosed from 2003 to 2013 in the Chinese PLA General Hospital were retrospectively analyzed. All cases were diagnosed via lung biopsy or surgical biopsy. There were 24 male and 16 female patients, aging from 15 to 84 years, including 10 patients with PPL and 30 with SPL. The main clinical manifestations of PPL were cough and chest pain, but 4 patients were asymptomatic. Chest CT showed lung mass in 8 patients and patchy opacities in 3. ¹⁸F-FDG PET/CT showed that the SUV(max) of lung lesions was 3.96-6.70 with a median value of 4.50. The pathological types of all PPL cases were non-Hodgkin lymphoma (NHL), and 4 patients were treated with surgery combined with chemotherapy, and 3 patients were treated with surgery alone. The main clinical manifestations of SPL were cough, superficial lymph node enlargement and fever, but 8 patients were asymptomatic. The chest CT revealed pleural effusions in 20, mediastinal and hilar lymph node enlargement in 14, patch opacities in 13 and multiple nodules in 6 patients. In addition to pulmonary involvement, PET/CT examination confirmed that cervical lymph nodes, thyroid, stomach and pancreas were also involved. The SUV(max) was from 2.40 to 19.60, with a median value of 5.70. Twenty-one cases of SPL were NHL and 9 were Hodgkin lymphomas (HL). Of these patients with SPL, 14 were treated with chemotherapy alone, 8 chemotherapy combined with radiotherapy, and 2 surgery combined with chemotherapy. The one-year survival rate of PPL was 100%, compared with 93.3% of SPL. The shortest survival time of PPL was 13 months, compared with 2 months of SPL. There were differences in the radiological features, pathological types and treatment between PPL and SPL. The chest CT manifestations of PPL were mainly lung masses, while those of SPL were mainly pleural involvement and mediastinal and hilar lymph node enlargement. The pathological type of PPL was all NHL while that of 9 cases of SPL was HL. Patients with PPL were mainly treated with surgical therapy, but SPL mainly with chemotherapy. PET/CT examination may be helpful for the diagnosis and staging of lung lymphoma. Since the misdiagnosis rate of pulmonary lymphoma was high, diagnosis must rely on lung tissue biopsy and immunohistochemistry. Compared with PPL, the prognosis of SPL is poorer.

Effects of microvascular density on primary pulmonary non-Hodgkin’s lymphoma (PPL)

This study aims to analyze 30 cases of primary pulmonary lymphoma (PPL) including treatment as well as follow-up information during the past 10 years and to investigate the correlation between microvessel density (MVD) and survival in patients with PPL. We reviewed all patients from October 2000 to October 2010. Patient demographics such as survival, recurrence, time to follow-up, and treatment mode were recorded. We also assessed MVD in the pretreated pulmonary lymphoma tissues of 30 previously untreated patients using α-CD34 immunohistochemical staining. The median age of the 30 patients was 46.9 years. With a median follow-up of 4.3 years (range, 2 to 10 years), the 5-year overall survival (OS) rate was 57 % and progression-free survival (PFS) was 44 %. High MVD, elevated serum lactate dehydrogenase (LDH), and B symptoms was significantly correlated with clinical features and shorter PFS (P(MVD) = 0.021, P(LDH) = 0.023, and P(B symptoms) = 0.005) and OS (P(MVD) = 0.028, P(LDH) = 0.032, and P(B symptoms) = 0.001). Application of surgical treatment improved the PFS (P = 0.024) and OS(P = 0.028) of patients with stage IE disease (patients who were nodal negative). The patient's stage predicted the outcome and guides the use of treatments. Patients with high MVD measured in the microenvironment had worse PFS/OS than those with low MVD expression. Patients who had B symptoms or elevated serum LDH had poor prognosis. Patients with lymph node involvement (stage IIE or greater) had poor prognosis.

Primary Pulmonary Lymphoma: Diagnosis and Follow-Up of 6 Cases and Review of an Uncommon Entity

Primary pulmonary lymphoma is an uncommon disease with a poorly defined management. We reviewed and followed the cases of primary pulmonary lymphoma in our institution to gather an estimation of this entity in our population. We reviewed the records of all patients with biopsy-proven lymphoma of the lung. The main diagnostic criterion for primary pulmonary lymphoma was the absence of extrapulmonary involvement. We identified 6 cases of primary pulmonary lymphoma among 33 patients with biopsy-proven lymphoma of the lung evaluated in our center in a 12-year period. A radiological abnormality in an asymptomatic patient was the most common clinical presentation. Four cases were low-grade and two cases high-grade non-Hodgkin PPL. Histopathologic analyses of lung specimens obtained by transbronchial biopsy were sufficient for a diagnosis in 5 of the 6 cases and avoided invasive surgical maneuvers. Most patients followed an indolent course, but with a tendency to relapse. Although clinical management of this entity is undefined, we feel bronchoscopic study, which is less aggressive than surgery, may be an adequate procedure for a diagnosis. Mono-chemotherapy using alkylating agents and careful clinical observation may be the best therapeutic approach for these patients, since most of them have favorable outcomes, whatever the treatment modalities.

A Case of Primary Pulmonary Lymphoma of Bronchus-Associated Lymphoid Tissue associated with Systemic Lupus Erythematous

A primary pulmonary malignant lymphoma is a rare disease. It is thought to be a category of non-Hodgkin's lymphoma arising from the bronchous-associated lymphoid tissue (BALT). The majority of primary pulmonary lymphomas are low-grade, small B-cell lymphomas, which are associated with Sjogren's syndrome and similar autoimmune disorders. A case of primary pulmonary low-grade B-cell lymphoma arising from the BALT was encountered in a patient with systemic lupus erythematosus. A 54-year-old man was admitted to the hospital for the evaluation of left pleuritic chest pain and multiple joint pain in both hands. Serologic tests for collagen vascular disease were performed. The results of ANA and anti-ds-DNA were all positive. The computed tomography of the chest showed patchy consolidations in the left lower lobe with a pleural effusion and a video-assisted thoracoscopic biopsy was performed. Here we report a case of a low-grade B-cell lymphoma of BALT in a patient with systemic lupus erythematosus with a review of the relevant literatures.

Primary Pulmonary Lymphoma—Clinical Review from a Single Institution in Singapore

Primary pulmonary lymphoma is a rare and vexing subset of extranodal non-Hodgkin's lymphoma. We report 11 cases and provide a brief literature review. We also highlight an unusual case of a relapsed peripheral T-cell primary lung lymphoma that underwent apparent spontaneous remission. Eleven cases of primary pulmonary lymphoma treated in our institution were studied for their clinical characteristics, behaviour, response to treatment and clinical outcome. The median duration of follow up was 26 months. The mean age was in the 50s and the presenting symptoms generally respiratory and non-specific. LDH levels did not correlate with either stage or grade of disease. Lower lobe involvement was most common and nodules and mass-like lesions the main radiologic feature. Small lymphocytic lymphoma accounted for the majority of cases and were indolent in behaviour. Good symptom control and radiologic response was achieved with chemotherapy in disseminated low grade lung lymphomas. Combination chemotherapy was effective in the aggressive lymphomas.In conclusion, Small lymphocytic lymphoma of the lung is an indolent disease with a long symptom-free survival even after recurrence. Our series confirms the clinical characteristics of primary pulmonary lymphoma. The role ofLing Zhi in effecting the spontaneous remission in the peripheral T-cell lymphoma is speculative.

Long-Standing Primary Pulmonary Lymphoma

Primary pulmonary lymphoma is a rare entity and bronchoscopy is reported to have a low diagnostic yield in lymphomas. A case of primary pulmonary lymphoma is presented where the patient had had sporadic respiratory symptoms and abnormal chest radiographs for the past 14 years. Diagnosis was confirmed by biopsies taken at bronchoscopy from the left lower lobe, where the mucosa had an unusual uniform gray-white appearance.

Lymphomes pulmonaires primitifs. À propos de 12 observations

Twelve cases of primary pulmonary lymphoma are presented. Most of them were localized to the lung, and had histologic features of low degree malignancy and B phenotype. Complete or partial response was obtained in most cases with chemotherapy alone or combined with surgery.

A Case of Primary Pulmonary Lymphoma: Cytologic, Histologic, and Immunocytologic Findings

Primary pulmonary lymphoma presenting with extensive pleural involvement and pleural effusion is rare. Diagnosis and classification by pleural fluid examination can be difficult. The case reported herein demonstrates the importance of cytologic examination, immunoelectrophoresis, and immunocytochemistry of pleural fluid in the diagnosis of primary pulmonary lymphoma. Diagnostic cytologic criteria are discussed. A complicating factor in this case was associated pulmonary tuberculosis, which raises the possibility of an etiologic relationship between chronic antigenic stimulation and immunoproliferative disorders.

The Surgical Treatment of Primary Malignant Lymphoma of the Lung

instances. As the fact that primary malignant lymphoma of the lung could be treated surgically has become accepted, the literature reporting the various results of treatment has included an increasing number of cases.4’6’7’9”3’7 In few reported cases, however, is the follow-up period sufficiently long to indicate clearly whether or not the surgeon was able to alter the course of the disease. Five years have passed since Cooley, McDonald and Clagett4 reported a series of nine cases of primary pulmonary lymphoma. A follow-up study of these patients and a report of experience with subsequent cases, therefore, were thought advisable. Material and Methods As a prelude to a clinicopathologic study of primary malignant lymphoma of the lung, a proper definition of conditions that form the basis for the assumption that the disease is primary in the lung is necessary. Accordingly for our study we decided that the condition first must be shown histologically by adequate biopsy to be a malignant lymphoma. To establish that the lymphoma is predominantly within the lung rather than a mediastinal structure requires direct examination, usually at thoracotomy. The procurement of a specimen that is definitely from a malignant lymphoma by either bronchoscopic or needle biopsy methods was not considered to be sufficient evidence that the process was primary in the lung. Our second condition, therefore, was an absence of evidence both at thoracotomy and in the case record that the malignant lymphoma in the lung was part of a disseminated process or that the lung was involved secondarily. Since lesions can be found in the lung in approxi