ABSTRACT
Extra marginal-zone lymphomas of the lung is a very rare tumor and it originates from bronchial-associated lymphoid tissue. A 68-yr-old woman presented with productive cough and dyspnea. A thorax computed tomography scan showed a 9 x 10 cm in size mass in the left lung and pleural effusion in the lower lobe of left lung. Positron emission tomography/computed tomography (PET/CT) revealed intense uptake foci at the upper and middle sites of left lung and slight uptake foci at the mediastinal lymph nodes which showed malignant involvement. After bronchoscopic biopsy, the diagnosis of pulmonary bronchial-associated lymphoid tissue (BALT) lymphoma was confirmed. At the end of the eight cycles weekly rituximab treatment, complete response was obtained by PET/CT findings. It is concluded that extended rituximab schedule is more effective and it would be beneficial to investigate the use of PET/CT in the diagnosis and evaluating of the treatment response of pulmonary BALT lymphoma.
Subject(s)
Aged , Female , Humans , Antibodies, Monoclonal, Murine-Derived/administration & dosage , Antineoplastic Agents/administration & dosage , Drug Administration Schedule , Fluorodeoxyglucose F18 , Lung Neoplasms/drug therapy , Lymphoma, B-Cell, Marginal Zone/drug therapy , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray ComputedABSTRACT
The bronchus-asociated lymphoid tissue(BALT) lymphoma is a low-grade primary malignant lymphoma that originates from bronchus associated lymphoid tissue. A 67-year-old woman was admitted for evaluation of cough, sputum, rhinorrhea which had persisted for one month. Physical examination showed decreased breathing sound on the left upper lung field. High resolution chest computed tomography demonstrated consolidation which showed air-bronchogram and surrounding ground glass opacity in left upper lobe. These findings implicated inactive tuberculosis, organizing pneumonia, or bronchiolo-alveolar carcinoma. The histologic findings from percutaneous needle aspiration biopsy revealed aggregated atypical small lymphoid cells with lymphoepithelial lesions. With immunohistochemical staining, the atypical lymphoid cells reacted positively with CD 20 antibody and negatively with CD 3 antibody. Thus, we could diagnosed her as a patient with BALT lymphoma. After left upper lobectomy, she has been well without recurrence of the disease for 14 months. In this country of Republic of Korea, it was the 1st case of BALT lymphoma surgically treated when histological diagnosis had been done. Based on this case, we wanted to demonstrate the importance of early histological diagnosis and treatment of BALT lymphoma.
Subject(s)
Aged , Female , Humans , Adenocarcinoma, Bronchiolo-Alveolar , Biopsy, Needle , Bronchi , Cough , Diagnosis , Glass , Lung , Lymphocytes , Lymphoid Tissue , Lymphoma , Needles , Physical Examination , Pneumonia , Recurrence , Republic of Korea , Respiratory Sounds , Sputum , Thorax , TuberculosisABSTRACT
BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.
Subject(s)
Humans , Middle Aged , B-Lymphocytes , Cough , Dyspnea , Fever , Glass , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Pneumonia , Radiography, Thoracic , Thoracoscopy , Thorax , Tomography, X-Ray ComputedABSTRACT
BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.
Subject(s)
Humans , Middle Aged , B-Lymphocytes , Cough , Dyspnea , Fever , Glass , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Pneumonia , Radiography, Thoracic , Thoracoscopy , Thorax , Tomography, X-Ray ComputedABSTRACT
Bronchus-associated lymphoid tissue (BALT) lymphoma is a rare disorder and it is a characteristic subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma that is classified as marginal zone lymphoma. We report here on a patient with rheumatoid arthritis who developed BALT lymphoma. She had no pulmonary symptoms and the pulmonary nodules were incidentally detected by routine chest radiography. Chest CT showed a 2.8cm sized ill-defined focal consolidation of homogenous attenuation in the posterobasal segment of the right lower lobe. The histological diagnosis from the wedge resection specimen revealed low grade B cell lymphoma of BALT. To the best of our knowledge, this case is the first to report BALT lymphoma that developed in a Korean patient with rheumatoid arthritis. BALT lymphoma should be included in the differential diagnosis of the pulmonary nodules in patients with rheumatoid arthritis.
Subject(s)
Humans , Arthritis, Rheumatoid , B-Lymphocytes , Diagnosis , Diagnosis, Differential , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Radiography , Thorax , Tomography, X-Ray ComputedABSTRACT
A sixty-five year old female was consulted for radiation therapy due to dyspnea. She was diagnosed as stage IV bronchial-associated lymphoid tissue (BALT) lymphoma at 5 months ago, and then received chemotherapy for 3 months. She have distressed from dyspnea originated from main bronchus obstruction, and should be supplied with oxygen via nasal prong. She underwent 36 Gy radiation therapy to bronchial mass that obstructs left main bronchus in 18 fractions for four weeks. Dyspnea was markedly improved after radiation therapy, and follow-up chest X-ray showed near complete resolution of mass and obstructed lung parenchyma. No recurrence was detected in lung for sixteen months. We experienced that radiation therapy for BALT lymphoma was effective for tumor control.
Subject(s)
Female , Humans , Bronchi , Drug Therapy , Dyspnea , Follow-Up Studies , Lung , Lymphoid Tissue , Lymphoma , Oxygen , Radiation Dosage , Recurrence , ThoraxABSTRACT
Non-Hodgkin's lymphoma very rarely involves the esophagus, occurring in less than 1% of patients with gastrointestinal lymphoma. A few cases of mucosa-associated lymphoid tissue (MALT) lymphoma of the esophagus have been reported in the English literature. To our knowledge, there has been no report of MALT lymphoma of the esophagus coexistent with bronchus-associated lymphoid tissue lymphoma (BALT) of the lung. This report details the radiological and clinical findings of this first concurrent case.
Subject(s)
Aged , Humans , Male , Bronchi/pathology , Esophageal Neoplasms/pathology , Lung Neoplasms/pathology , Lymphoma/pathology , Lymphoma, B-Cell, Marginal Zone/pathology , Neoplasms, Multiple Primary/pathologyABSTRACT
Primary pulmonary lymphoma is rare, especially lymphomas arising in and limited to the tracheal wall without pulmonary parenchymal involvement are extremely rare. Bronchus-associated lymphoid tissue (BALT) lymphoma accounts for the majority of tracheal lymphomas. BALT lymphoma reveals distinct clinicopathologic features and remains localized for prolonged periods. The diagnosis is made histopathologically. Optimal management of these rare lesions has not been established. But, chemotherapy and radiation therapy all have been tried with favorable short-term results. The prognosis of BALT lymphoma is relatively good. We present here a case of BALT lymphoma of the tracheal wall which had responded to bronchoscopic ND-YAG laser therapy and local radiation therapy.
Subject(s)
Diagnosis , Drug Therapy , Lasers, Solid-State , Lymphoid Tissue , Lymphoma , Prognosis , TracheaABSTRACT
A bronchus-associated lymphoid tissue(BALT) lymphoma of the lung is a rare disorder of patients with Sjogren's syndrome. A 49-year-old woman was admitted for an evaluation of exertional dyspnea and general weakness which had persisted for two years. The patient had suffered from dry mouth and dry eyes for five years. The physical examinations showed a coarse breath sound with inspiratory crackles on the whole lung field, particularly on the both basal lungs. The laboratory data disclosed high titers of anti-nuclear antibodies, and anti-SSA (Ro), and anti-SSB(La) antibodies. Chest radiographs demonstrated the presence of bilateral, diffuse, reticulonodular densities in both lungs. Thin-section CT scans showed diffusely distributed mosaic pattern of an inhomogeneous attenuation extending over the entire lung zone. The histological findings from an open-lung biopsy specimen revealed an accumulation of lymphoid cells around the bronchioles and an extension of malignant lymphoma cells from the bronchiolar epithelium toward the alveolar space. Immunohistochemically, the neoplastic cells reacted positively to the CD 20 antigen and were focally positive for the UCHL 1 antigen. The histological diagnosis was consistent with a low grade marginal zone B-cell lymphoma originating in the BALT. Here, we present a case of a histologically proven BALT lymphoma of the lung in a patient with primary Sjogren's Syndrome.
Subject(s)
Female , Humans , Middle Aged , Antibodies , Biopsy , Bronchioles , Diagnosis , Dyspnea , Epithelium , Lung , Lymphocytes , Lymphoma , Lymphoma, B-Cell, Marginal Zone , Mouth , Physical Examination , Radiography, Thoracic , Respiratory Sounds , Sjogren's Syndrome , Tomography, X-Ray ComputedABSTRACT
The primary mucosa-associated lymphoid tissue(MALT) lymphoma of the lung is a rare low grade B cell lymphoma arising from bronchus-associated lymphoid tissue(BALT) which had been regarded as pseudolymphoma. It has the characteristic histologic with monoclonal B cells of centrocyte-like lymphoid cells and a lymphoepithelial lesion. Clinically it shows an indolent clinical course course and much more favorable prognosis than lymphoma of other site. We report 3 cases of the pulmonary malignant lymphoma of BALT, which was confirmed by lung biopsy, immunohistochemistry and PCR assay.
Subject(s)
B-Lymphocytes , Biopsy , Immunohistochemistry , Lung , Lymphocytes , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Polymerase Chain Reaction , Prognosis , PseudolymphomaABSTRACT
Malignant lymphoma arising from mucosa-associated lymphoid tissue (MALT) represents distinct clinicopathologic features and remains localized for prolonged periods. We report a case of low grade B cell lymphoma of bronchus-associated lymphoid tissue (BALT). A 60-year-old female had a long-standing cough, sputum and intermittent fever for 10 years. In 1984, the chest radiography showed increased hazy density in both upper lungs. Although she had been treated by antituberculous medication under clinical diagnosis, there was no improvement. In 1995, open lung biopsy was carried out. Histologically, it showed massive nodular or diffuse infiltration of centrocyte-like cells in bronchus and parenchyme with pleural invasion. On immunohistochemical stain, they were positive for LN-2 and L26 and negative for UCHL-1, LN-1 and LN-3. In polymerase chain reaction (PCR), Ig heavy chain gene rearrangement was detected. The patient was well for 6 months after the biopsy.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Bronchi , Cough , Diagnosis , Fever , Gene Rearrangement , Lung , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Polymerase Chain Reaction , Radiography , Sputum , ThoraxABSTRACT
Primary pulmonary lymphoma (PPL) is an uncommon tumor, which constitutes 3-4% of all exuanodal lymphomas and 0.3-0.5% of all primary pulmonary malignant tumors. Low-grade B-cell lymphomas of bronchus-associated lymphoid tissue (BALT) accounted for the majority of PPL. This BALT lymphomas are frequently asymptomatic and have an excellent prognosis and an indolent clinical course by contrast with T-cell type. Therefore, determination of the B- or T-immunophenotype of the tumor cells is known 13 be very important from a clinical aspect Recent advances in immunohistochemical techniques, cytogenetics, and molecular biology have allowed better definition of type, maturation and clonality of lymphoma cells and have made it possible to better understand the PPL. We experienced an asymptomatic 43-year-old man who was evaluated for infiltrates on both sides discovered incidentally after a routine chest roentgenogram. He was eventually diagnosed as low-grade B-cell lymphoma of BALT by immunohistochemical staining from specimens obtained by open lung biopsy. He was treated with combination chemotherapy. At follow up 12 months following initial diagnosis he remains in stable. We report this case, who showed a relatively favorable prognosis and indolent clinical course compatible with low-grade B-cell lymphoma.
Subject(s)
Adult , Humans , B-Lymphocytes , Biopsy , Cytogenetics , Diagnosis , Drug Therapy, Combination , Follow-Up Studies , Lung , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Molecular Biology , Prognosis , T-Lymphocytes , ThoraxABSTRACT
The pulmonary lymphomas were thought to originate in specialized lymphoid tissue that is associated with bronchial mucosa(bronchus-associated lymphoid tissue(BALT)), and they were categorized as mucosa-associated lymphoid tissue(MALT) lymphoma. MALT lymphoma consists of a monoclonal population of cell, in contrast to reactive lymphoid proliferation, which consists of polyclonal cells. Lymphoma arising from MALT(=MALToma) represents a distinct clinicopathologic features. It is usually localized to their original site for a long time and shows much more favorable prognosis than lymphoma at other site. Some MALT lymphoma could arise simultaneously or successively in different organ or that cells from MALT lymphoma might circulate and give rise to another lymphoma by homing in the MALT of another organ, such as breast, salivary gland, stomach etc, and can be multifocally disseminated or recurred. We report a case of low-grade B-cell lymphoma of the mucosa-associated lymphoid tissue(MALT) of the lung, which was confirmed by open lung biopsy, immunohistochemistry and PCR assay.