Objective To explore the clinical characteristics, diagnosis and treatment methods of pulmonary mucosa-associated lymphoid tissue lymphoma.
Methods Clinical manifestations, laboratory examinations, imaging, diagnosis and treatment data of 23 patients with pulmonary mucosa-associated lymphoma were collected and related literatures were reviewed.
Results Among the 23 patients, 14 were males and 9 females, aged 22 to 71 years old, with a median age of 58 years old. Seven patients were found in physical examination, 15 patients showed respiratory symptoms, and 1 patient was diagnosed with flatness on percussion. According to the pulmonary CT scan, 10 patients showed large consolidations, 9 patients showed mass shadows with air bronchograms, 10 patients showed nodular shadows, 1 patient showed small reticular shadows, and 1 patient was observed with subcarinal mass in the mediastinum; 1 patient was observed with a decreased lung volume. Immunohistochemistry examination showed CD20 (+), cyclind-1 (-), and Ki-67 index was from 5% to 25%. Ten patients were treated with chemotherapy, 9 patients were treated with surgery, 1 patient was treated with radiotherapy and surgery, and 3 patients were untreated.
Conclusions Pulmonary mucosa-associated lymphoid tissue lymphoma is a low-moderate malignant tumor, with insidious clinical onset, and patients usually go for treatment due to physical examination and mild respiratory symptoms. Imaging findings are mainly pulmonary consolidation and mass shadows associated with air bronchograms. Confirmed diagnosis is primarily made by pathology and immunohistochemistry. Currently, there is still some controversy over a variety of treatment options, including observation, surgery, surgery combined with chemotherapy, chemotherapy alone, and radiotherapy. The patients' prognosis and survival time are both excellent.
Citation:
LiangXiaoyan, LiHongxia, CaiShaohua. Primary Pulmonary Mucosa-associated Lymphoid Tissue Lymphoma: A 23-Case Report and Literature Review. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(5): 477-481. doi: 10.7507/1671-6205.2015116
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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Kang HS, Lee HY, Kim JJ, et al. An unusual presentation of pulmonary mucosa-associated lymphoid tissue lymphoma as diffuse pulmonary infiltrates with spontaneous regression. Cancer Res Treat, 2014 Sep 15[Epub ahead of print]. http://dx.doi.org/10.4143/crt.2014.016.].
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Kido T, Yatera K, Noguchi S, et al. Detection of MALT1 gene rearrangements in BAL fluid cells for the diagnosis of pulmonary mucosa-associated lymphoid tissue lymphoma. Chest, 2012, 141:176-182.
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Santos IG, Marchiori E, Zanetti G, et al. Primary pulmonary mucosa-associated lymphoid tissue lymphoma computed tomography findings:a case report. Cases J, 2009, 2:6329.
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Okamura I. Rituximab monotherapy as a first-line treatment for pulmonary mucosa-associated lymphoid tissue lymphoma. Int J Hematol, 2015, 101:46-51.
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Wang L, Xia ZJ, Zhang YJ, et al. Radical surgery may be not an optimal treatment approach for pulmonary MALT lymphoma. Tumour Biol, 2015, 36:6409-6416.
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- 1. Cadranel J, Wislez M, Antoine M. Primary pulmonary lymphoma. Eur Respir J, 2002, 20:750-762.
- 2. Kim JH, Lee SH, Park J, et al. Primary pulmonary non-Hodgkin's lymphoma. Jpn J Clin Oncol, 2004, 34:510-514.
- 3. Ishii Y, Tomita V, Takasaki H, et al. Clinical features of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Hematol Oncol, 2012, 30:186-189.
- 4. Ahmed S, Kussic SJ, Siddiqui AK, et al. Bronchial-associated lymphoid tissue lymphoma:a clinical study of a rare disease. Eur J Cancer, 2004, 40:1320-1326.
- 5. Harris NL, Isaacson PG. What are the criteria for distinguishing MALT from non-MALT lymphoma at extranodal sites? Am J Clin Pathol, 1999, 111(1 Suppl 1):S126-132.
- 6. Kang HS, Lee HY, Kim JJ, et al. An unusual presentation of pulmonary mucosa-associated lymphoid tissue lymphoma as diffuse pulmonary infiltrates with spontaneous regression. Cancer Res Treat, 2014 Sep 15[Epub ahead of print]. http://dx.doi.org/10.4143/crt.2014.016.].
- 7. Kido T, Yatera K, Noguchi S, et al. Detection of MALT1 gene rearrangements in BAL fluid cells for the diagnosis of pulmonary mucosa-associated lymphoid tissue lymphoma. Chest, 2012, 141:176-182.
- 8. Santos IG, Marchiori E, Zanetti G, et al. Primary pulmonary mucosa-associated lymphoid tissue lymphoma computed tomography findings:a case report. Cases J, 2009, 2:6329.
- 9. Okamura I. Rituximab monotherapy as a first-line treatment for pulmonary mucosa-associated lymphoid tissue lymphoma. Int J Hematol, 2015, 101:46-51.
- 10. Wang L, Xia ZJ, Zhang YJ, et al. Radical surgery may be not an optimal treatment approach for pulmonary MALT lymphoma. Tumour Biol, 2015, 36:6409-6416.