ABSTRACT
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
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.