Primary Pulmonary non-Hodgkin Lymphoma Research Articles

Primary Non-Hodgkin Lymphoma Lung

Lymphomas are a heterogeneous group of malignancies that originate from the neoplastic transformation of lymphocytes. Primary pulmonary non-Hodgkin lymphoma is a rare entity with marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) which is the most common subtype is a low-grade lymphoma accounting for <0.5% of all primary lung neoplasms. The most common presentation is a mass discovered on a chest radiograph in an asymptomatic patient, with symptomatic patients presenting with cough, dyspnea, chest pain, and hemoptysis. On computerized tomography, multiple bilateral lesions are commonly seen in pulmonary MALT lymphoma with consolidation, nodule, and mass being the main morphological patterns. We present two cases diagnosed with marginal zone lymphoma of the lung which is an indolent lymphoma and the most common subtype in the lung.

Diagnostic and prognostic factors for patients with primary pulmonary non-Hodgkin's lymphoma: A 16-year single-center retrospective study.

Primary pulmonary non-Hodgkin's lymphoma (PP-NHL) is a rare entity with non-specific symptoms and radiographic findings, as well as a difficult preoperative diagnosis. A limited number of studies have described PP-NHL in Chinese patients. The goal of the present study was to improve early diagnosis by examining prognostic factors in patients with PP-NHL. Therefore, a total of 29 patients with PP-NHL were included in the study between January 2001 and June 2017, including 14 with aggressive-type and 15 with indolent-type lymphomas (10 male, 19 female; median age, 50.3 years; range, 19-87 years). Pulmonary nodules and masses (55.2%) were the most common radiographic features. The diagnostic yield was 80% (12/15) by endobronchial biopsy or transbronchial lung biopsy and 100% by computed tomography (CT)-guided percutaneous needle lung biopsy (11/11) or surgery (8/8). Elevated lactate dehydrogenase levels and systemic symptoms were observed considerably more often in patients with aggressive disease than in those with indolent disease. The 1-, 3- and 5-year overall survival (OS) rates were 42, 32, and 21%, respectively, for all patients, 72, 57 and 43%, respectively, for patients with indolent lymphomas, and 13, 6 and 0%, respectively, for patients with aggressive lymphomas. The median OS rate for all patients was 12.0 months; however, the OS rate for patients with aggressive lymphomas was significantly shorter compared with those with indolent lymphomas (7.1 months vs. 16.6 months; P=0.002). Aggressive vs. indolent lymphoma status was indicated to be an independent prognostic factor for poor 5-year OS rate (hazard ratio, 5.98; P=0.014). In conclusion, bronchoscopic and CT-guided percutaneous needle lung biopsies were the most useful and least invasive procedures for diagnosing PP-NHL. Furthermore, aggressive PP-NHL was highly associated with poor 5-year OS rate and a poor prognosis.

Coincidental Observation of Global Hypometabolism in the Brain on PET/CT of an AIDS Patient With High-Grade Pulmonary Non-Hodgkin Lymphoma

AIDS-related dementia complex is the most severe form of cognitive dysfunction in a patient infected with human immunodeficiency virus. The use of FDG PET/CT to diagnose AIDS-related dementia complex has been studied previously and shows various specific metabolic patterns from striatal hypermetabolism in early asymptomatic stage to global hypometabolism in advanced stages. We present a case of a 49-year-old patient with long-standing human immunodeficiency virus infection, where global brain hypometabolism was noted coincidentally on FDG PET/CT done for initial staging of primary pulmonary non-Hodgkin lymphoma.

Clinical analysis of 19 patients with primary pulmonary non-Hodgkin lymphoma

Objective To discuss the diagnosis, treatment and prognostic factors of primary pulmonary non-Hodgkin lymphoma (PPNHL). Methods A retrospective analysis was performed on the clinical data of 19 patients from January 2000 to October 2014, who was diagnosed as PPNHL in Henan Cancer Hospital with complete data. The Kaplan-Meier method and Log-rank test were used in the survival analysis and the difference analysis, respectively. Results There were 13 patients with primary pulmonary mucosa-associated lymphoid tissue (PPMALT) lymphoma in the group and the others were non-PPMALT lymphoma. The 5-year overall survival rate of the 19 patients was 72.3 %, among which patients with PPMALT lymphoma or non-PPMALT lymphoma had statistically significance (83.3 % vs 50.0 %, P= 0.047). Conclusions PPNHL is very rare, lacking specificity of its clinical manifestations and imaging findings. Pathology and immunohistochemistry are important to its diagnosis. Though PPNHL lacks uniform treatment programs, most of them are MALT lymphoma with good prognosis. Key words: Lymphoma, non-Hodgkin; Lung; Diagnosis; Therapy

Primary pulmonary lymphoma: About five cases and literature review

Primary pulmonary lymphoma is a very rare neoplasm that represents only 3-4% of extranodal non-Hodgkin lymphoma (NHL), less than 1% of NHL and only 0.5-1% of primary pulmonary malignancies. Primary pulmonary NHL is most commonly represented by marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma). The clinical characteristics, methods of treatment, and outcomes are not well-elucidated. We, therefore, reviewed the medical records of five Moroccan patients who were pathologically and clinically diagnosed as primary pulmonary lymphoma and treated in our institute of oncology.

Clinical and radiological features of primary pulmonary non-Hodgkin lymphoma

Clinical and radiological features of primary pulmonary non-Hodgkin lymphoma

A Case of Synchronous Lung Adenocarcinoma and Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Type

Abstract SESSION TYPE: Cancer Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Extranodal marginal zone B-cell lymphoma (extranodal MZL) of mucosa-associated lymphoid tissue (MALT) type, also called MALT lymphoma, is a distinct subgroup of non-Hodgkin's lymphoma (NHL). More than two thirds of primary pulmonary NHLs are extranodal MZLs but they account for less than 0.5% of all primary lung neoplasms. Only a few cases of simultaneous lung cancer and pulmonary extranodal MZL have been reported. Also, it is extremely rare that primary extranodal MZL occurs in the large airways. To our knowledge, only one case of lung cancer coexisting with extranodal MZL of the large airway has been reported. We report a case of synchronous lung adenocarcinoma and primary extranodal MZL of the left main bronchus.CASE PRESENTATION: A 60-year old woman was referred to our hospital with a pulmonary nodule in the right upper lung seen on chest radiograph during a routine health checkup. She had never smoked. A chest radiograph showed a nodule in the right upper lung. A chest computed tomographic (CT) scan showed a peripherally located 2.4 × 1.8 cm sized solid nodule in the anterior segment of the right upper lobe. Fluorine 18-labeled fluorodeoxyglucose (FDG)-positron emission tomography (PET)-CT scan revealed abnormal FDG uptake in the right upper lobe lung nodule and in the right hilar lymph node. She underwent CT image-guided percutaneous core needle biopsy of the nodule in the right upper lobe. Additionally, a flexible bronchoscopic examination was performed to identify the endobronchial lesion. At bronchoscopy, a few small variable-sized protrusions were observed in the proximal left main bronchus and a biopsy was performed . The needle biopsy specimens of the right lung nodule showed non-mucinous adenocarcinoma. Immunohistochemical stains were positive for CK7 and TTF-1, and negative for CK20. Histopathology of the bronchoscopic biopsy specimens of the left main bronchus lesions showed diffuse proliferation of atypical lymphoid cells beneath the mucosal epithelium. Immunohistochemical stains showed diffuse strong positive for CD20, and were negative for CKpan and CD10. The bronchial lesion was diagnosed as extranodal marginal zone B-cell lymphoma of MALT type. She underwent right upper lobectomy and lymph node dissection for the lung adenocarcinoma. However, she did not receive specialized therapy for extranodal MZL of the left main bronchus. Since then she has been observed regularly.DISCUSSION: Synchronous primary malignancy and extranodal MZL in the same anatomical sites, such as stomach and lung is very unusual. To our knowledge, there is only one other report showing the coexistence of lung cancer and pulmonary extranodal MZL of the large airway. However, in that case, the histology of lung cancer was squamous cell carcinoma. The present case is the first report of the simultaneous occurrence of lung adenocarcinoma and pulmonary extranodal MZL of the large airway. The cause of the synchronous lesions in our case is uncertain. We postulate that a pulmonary extranodal MZL may coincide with a lung adenocarcinoma by accident. Little is known about the mechanism of the simultaneous occurrence of these different tumors. Moreover, the two different malignancies were located in different lungs in this case. However, other possible causes may include common etiologic factors and genetic or epigenetic alterations participating in the development of both the lung adenocarcinoma and extranodal MZL. Further studies will be required to clarify the relationship between lung adenocarcinoma and pulmonary extranodal MZL. It is necessary to accumulate more cases with both malignancies.CONCLUSIONS: In conclusion, we report a unique case of pulmonary extranodal MZL of main bronchus coexisting with lung adenocarcinoma. The patient was asymptomatic and was diagnosed with pulmonary extranodal MZL by chance during investigation of an endobronchial lesion.1) Jaffe ES, Harris NL, Stein H, Vardiman JW. World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of Haematopoietic and Lymphoid tissue. Lyon: International Agency for Research on Cancer; 2001.DISCLOSURE: The following authors have nothing to disclose: Chi Young Jung, Young June JeonNo Product/Research Disclosure InformationKeimyung University Dongsan Hospital, Daegu, Republic of Korea.

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

Primary pulmonary non-Hodgkin's lymphoma (PPNHL) of the lung occurs very rarely. To clarify clinical features, treatment alternatives and outcomes, we evaluated our surgically diagnosed PPNHL cases. A retrospective review of PPNHL cases from January 2004 to December 2009 was performed. Demographic and clinical data are presented as means or medians. Overall survival was estimated using the Kaplan-Meier method. Survival rates were compared using the log-rank test. A p value < 0.05 was considered significant. Patients were eight males and two females with a median age of 50 years (range, 29-76 years). In 40% of the patients, antigenic stimulation, immune-suppression or auto-immune disease could not been found. All patients were symptomatic at presentation. Surgical procedures were needed to obtain a diagnosis (nine wedge resections and one pneumonectomy). Eight patients had an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), and two had diffuse large B-cell lymphomas. The patients were treated with observation (pneumonectomy case), chemotherapy (n= 7), and chemotherapy and radiotherapy (n= 1). Five-year survival was 76%. Difference in survival rates of patients with bilateral vs. unilateral disease were not statistically different. On contrary of the literature, PPNHL can occur with absence of antigenic stimulation, and patients generally have some symptoms. Chemotherapy or surgery can be used to treat PPNHL. Patient survival is good.

Primary pulmonary non‐Hodgkin's lymphoma: A retrospective analysis of 29 cases in a Chinese population

Primary pulmonary non-Hodgkin's lymphoma (PPL) is a rare extranodal lymphoid neoplasm. The present knowledge of this entity is vague and minimal. A total of 29 patients diagnosed with PPL at Sun Yat-Sen University Cancer Center in China were retrospectively analyzed. Nineteen patients had mucosa-associated lymphoid tissue (MALT) lymphoma, nine had diffuse large B-cell lymphoma (DLBCL), and one had plasmacytic lymphoma. Six patients received PET/CT scans before treatment, and mean maximum standardized uptake values (mSUVs) were much higher in the DLBCL cases (n = 3) than in the MALT lymphoma cases (n = 3). The 3-year overall survival (OS) rate was 79.3%. Cox regression analysis showed that hilar/mediastinal lymphadenopathy (LAP) was an independent predictor of survival (P = 0.029). The mean survival time (MST) was 75.5 months for patients who underwent surgery and 65.7 months for those who didn't (P = 0.38). The MST was 77.4 months for patients treated with rituximab and 54.1 months for those not treated with rituximab (P = 0.101). Clinical characteristics in our study were partly similar to those previously reported. However, we found that hilar/mediastinal LAP seemed to be an effective prognostic factor in Chinese PPL patients. The role of surgery and rituximab in the management of PPL warrants further investigation.

Clinical Feature of Primary Pulmonary Non-Hodgkin's Lymphoma

【Background: Primary non-Hodgkin's lymphoma of the lung is a rare entity. It is represented commonly as marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. Although there have been a few reviews of this lymphoma, clinical features, radiologic findings, management and prognosis have not been well defined. Methods: We reviewed the medical records of 24 patients with primary pulmonary lymphoma between January 1995 and September 2008; all diagnoses had been confirmed based on pathology. Results: The median follow-up time was 42.3 months (range, 0.1~131.2 months). Five (20.8%) patients were asymptomatic, 17 (70.8%) patients had pulmonary symptoms, and the remaining 2 (8.3%) patients presented with constitutional symptoms. There were 16 (66.7%) patients with MALT lymphoma, 4 (16.7%) patients with diffuse large B-cell lymphoma and 4 (16.7%) patients with lymphoma that had not received a WHO classification. Radiologic findings of primary pulmonary lymphoma were diverse and multiple nodule or consolidation was the most common finding regardless of pathologic lymphoma type. PET scan was carried out in 13 (54.2%) patients and all lesions showed notable FDG uptake. MALT lymphoma showed a trend of better prognosis (3-year survival, 78.8% vs. 70.0%; 5-year survival, 78.8% vs. 52.5%; p=0.310) than non-MALT lymphoma. Conclusion: Primary non-Hodgkin's lymphoma of the lung occurs with nonspecific clinical features and radiologic findings. MALT lymphoma is the most common pathologic type of primary pulmonary lymphoma. This entity of lymphoma appears to have a good prognosis and in this study, there was a trend of better outcome than non-MALT lymphoma.】

Primary pulmonary non-Hodgkin lymphoma of T cell: case report

患者男,33岁.于1个月前开始不明原因发热,体温最高达39℃;伴少量咳嗽,痰少量、呈白色偶带黄色,痰中无血丝.当地医院CT检查:两肺有多发结节影,拟诊为韦格肉芽肿,予抗感染治疗,为求进一步诊治来我院.体检:体温37.1℃;脉搏92 次/min;呼吸22 次/min;血压134/83 mm Hg(1 mm Hg=0.133 kPa);神志清,全身浅表未触及肿大淋巴结,胸骨无压痛,两肺未闻及干、湿性啰音。

CT scan findings of primary pulmonary non-Hodgkin's lymphoma and their relation to pathological features

To investigate the CT scan findings of primary pulmonary non-Hodgkin's lymphoma (PPNHL) and their relation to pathological features. The CT scan findings of 17 PPNHL cases confirmed pathologically from August 1992 to June 2007 were analyzed in relation to their pathological foundation. In 17 cases the CT findings showed: 1) Five were single mass or nodule, including 3 with air-bronchograms, 1 with straddling-lobe distribution and 3 with slight enhancement; 2) One was multi-nodules with air-bronchograms; 3) Six were consolidation with air bronchogram,including 3 with straddling-lobe distribution and 3 with slight enhancement; 4) Five were combined changes, including 5 with air-bronchograms, 2 with straddling-lobe distribution and 4 with slight enhancement. The CT features of PPNHL corresponded to their pathological process and pathological features. Primary pulmonary non-Hodgkin's lymphoma should be considered when CT scan shows variety of images found in one patient, middle lobe of right lung involved, air-bronchograms and straddling-lobe distribution in consolidation with slight enhancement.

Primary pulmonary non-Hodgkin's lymphoma.

Primary pulmonary non-Hodgkin's lymphoma is a very rare neoplasm. It is represented most commonly by marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. Although there have been a few reviews of this lymphoma, clinical features, diagnostic procedure, optimal management and prognostic factors have not been well defined. We reviewed the medical records of 24 patients who were pathologically and clinically diagnosed as primary pulmonary lymphoma between September 1995 and June 2003. There were 13 patients with MALT lymphoma and two with MALT lymphoma accompanied by large B-cell lymphoma, seven with diffuse large B-cell lymphoma and two with anaplastic large cell lymphoma. Half the patients were asymptomatic at presentation; 46% had respiratory symptoms and 16.7% had B-symptoms. Initial radiological findings were variable including nodules, masses, infiltrates or consolidation. The majority of patients (66.7%) needed surgical approaches (open thoracotomy or video-assisted thoracoscopy) for definite diagnosis. Bronchoscopy was performed in 83%, but only 30% showed a diagnostic yield. The 13 patients with MALT lymphoma were treated with a variety of modalities such as observation, surgery and single or combination chemotherapy, and combination chemotherapy was administered to 11 patients with non-MALT lymphoma regardless of surgery. The overall survival rate at 3 years for all 24 patients was 86% with a median follow-up of 32 months. Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify prognostic factors.