Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Clinical Feature of Primary Pulmonary Non-Hodgkin's Lymphoma

폐의 원발성 비호지킨림프종의 임상상

  • Oh, Dong-Kyu (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Roh, Jae-Hyung (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Jin-Woo (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong-Soon (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 오동규 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 노재형 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 송진우 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 김동순 (울산대학교 의과대학 서울아산병원 호흡기내과학교실)
  • Received : 2010.07.20
  • Accepted : 2010.09.27
  • Published : 2010.11.30
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Abstract

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.

Keywords

References

  1. Ferraro P, Trastek VF, Adlakha H, Deschamps C, Allen MS, Pairolero PC. Primary non-Hodgkin's lymphoma of the lung. Ann Thorac Surg 2000;69:993-7. https://doi.org/10.1016/S0003-4975(99)01535-0
  2. Kurtin PJ, Myers JL, Adlakha H, Strickler JG, Lohse C, Pankratz VS, et al. Pathologic and clinical features of primary pulmonary extranodal marginal zone B-cell lymphoma of MALT type. Am J Surg Pathol 2001;25: 997-1008. https://doi.org/10.1097/00000478-200108000-00003
  3. Ooi GC, Chim CS, Lie AK, Tsang KW. Computed tomography features of primary pulmonary non-Hodgkin's lymphoma. Clin Radiol 1999;54:438-43. https://doi.org/10.1016/S0009-9260(99)90828-0
  4. Cordier JF, Chailleux E, Lauque D, Reynaud-Gaubert M, Dietemann-Molard A, Dalphin JC, et al. Primary pulmonary lymphomas: a clinical study of 70 cases in nonimmunocompromised patients. Chest 1993;103:201-8. https://doi.org/10.1378/chest.103.1.201
  5. Koss MN, Hochholzer L, Nichols PW, Wehunt WD, Lazarus AA. Primary non-Hodgkin's lymphoma and pseudolymphoma of lung: a study of 161 patients. Hum Pathol 1983;14:1024-38. https://doi.org/10.1016/S0046-8177(83)80258-5
  6. Cadranel J, Wislez M, Antoine M. Primary pulmonary lymphoma. Eur Respir J 2002;20:750-62. https://doi.org/10.1183/09031936.02.00404102
  7. Fiche M, Caprons F, Berger F, Galateau F, Cordier JF, Loire R, et al. Primary pulmonary non-Hodgkin's lymphomas. Histopathology 1995;26:529-37. https://doi.org/10.1111/j.1365-2559.1995.tb00271.x
  8. Fisher RI, Dahlberg S, Nathwani BN, Banks PM, Miller TP, Grogan TM. A clinical analysis of two indolent lymphoma entities: mantle cell lymphoma and marginal zone lymphoma (including the mucosa-associated lymphoid tissue and monocytoid B-cell subcategories): a Southwest Oncology Group study. Blood 1995;85:1075-82.
  9. Habermann TM, Ryu JH, Inwards DJ, Kurtin PJ. Primary pulmonary lymphoma. Semin Oncol 1999;26: 307-15.
  10. Morton LM, Turner JJ, Cerhan JR, Linet MS, Treseler PA, Clarke CA, et al. Proposed classification of lymphoid neoplasms for epidemiologic research from the Pathology Working Group of the International Lymphoma Epidemiology Consortium (InterLymph). Blood 2007; 110:695-708. https://doi.org/10.1182/blood-2006-11-051672
  11. Zinzani PL, Tani M, Gabriele A, Poletti V, Stefoni V, Alinari L, et al. Extranodal marginal zone B-cell lymphoma of MALT-type of the lung: single-center experience with 12 patients. Leuk Lymphoma 2003;44:821-4. https://doi.org/10.1080/1042819031000067972
  12. Begueret H, Vergier B, Parrens M, Lehours P, Laurent F, Vernejoux JM, et al. Primary lung small b-cell lymphoma versus lymphoid hyperplasia: evaluation of diagnostic criteria in 26 cases. Am J Surg Pathol 2002; 26:76-81. https://doi.org/10.1097/00000478-200201000-00009
  13. Nicholson AG, Wotherspoon AC, Diss TC, Hansell DM, Du Bois R, Sheppard MN, et al. Reactive pulmonary lymphoid disorders. Histopathology 1995;26:405-12.
  14. Bienenstock J, Johnston N, Perey DY. Bronchial lymphoid tissue. I. Morphologic characteristics. Lab Invest 1973;28:686-92.
  15. Kim JH, Lee SH, Park J, Kim HY, Lee SI, Park JO, et al. Primary pulmonary non-Hodgkin's lymphoma. Jpn J Clin Oncol 2004;34:510-4. https://doi.org/10.1093/jjco/hyh095
  16. Vanden Eynden F, Fadel E, de Perrot M, de Montpreville V, Mussot S, Dartevelle P. Role of surgery in the treatment of primary pulmonary B-cell lymphoma. Ann Thorac Surg 2007;83:236-40. https://doi.org/10.1016/j.athoracsur.2006.08.026
  17. Kim JB, Park CK, Park NH, Kum DY, Noh DS, Lee JH, et al. Clinical analysis of primary malignant lymphoma of the lung. Korean J Thorac Cardiovasc Surg 2007; 40:435-40.
  18. Bae YA, Lee KS, Han J, Ko YH, Kim BT, Chung MJ, et al. Marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: imaging findings in 21 patients. Chest 2008;133:433-40. https://doi.org/10.1378/chest.07-1956
  19. Beal KP, Yeung HW, Yahalom J. FDG-PET scanning for detection and staging of extranodal marginal zone lymphomas of the MALT type: a report of 42 cases. Ann Oncol 2005;16:473-80. https://doi.org/10.1093/annonc/mdi093
  20. Hoffmann M, Kletter K, Becherer A, Jager U, Chott A, Raderer M. 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) for staging and follow-up of marginal zone B-cell lymphoma. Oncology 2003;64: 336-40. https://doi.org/10.1159/000070290
  21. Hoffmann M, Kletter K, Diemling M, Becherer A, Pfeffel F, Petkov V, et al. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa- associated lymphoid tissue (MALT)-type. Ann Oncol 1999;10:1185-9. https://doi.org/10.1023/A:1008312726163
  22. Li G, Hansmann ML, Zwingers T, Lennert K. Primary lymphomas of the lung: morphological, immunohistochemical and clinical features. Histopathology 1990; 16:519-31. https://doi.org/10.1111/j.1365-2559.1990.tb01157.x