Clinical features and diagnosis analysis of primary pulmonary lymphoma via endobronchial ultrasound / 中国内镜杂志

ABSTRACT

Objective To investigate the clinical diagnosis features of primary pulmonary lymphoma (PPL). Methods 11 cases of primary pulmonary lymphoma, confirmed by pathological examinations from January 2015 to March 2017, were studied. Most of them (10 cases) were diagnosed by endobronchial ultrasound. Results The study group consisted of 7 male (63.6％) and 4 female (36.4％) patients, aged from 35 to 72 years. 8 of 11 cases (72.7％) were more than 50 years old. The clinical symptoms consist of cough (63.6％), sputum (45.5％), breathlessness(36.4％), 2 cases were asymptomatic. The pulmonary imaging manifestation consists of four different patterns pneumonic (72.7％);nodular or mass (45.5％); bronchovascular-lymphangitic (9.1％); milliary- hematogenous (9.1％). Air bronchograms (8 cases, 72.7％) were the common accompanying signs, typically taking the shape of withered arborization. Many cases (72.7％) were misdiagnosed, first as pneumonia or organizing pneumonia. Conclusion Primary lymphoma of the lung occurs with nonspecific clinical features, often initial misdiagnosed as pneumonia or organizing pneumonia, but it has some characteristics on radiology, such as multiple lesions, lesions accompanied with air bronchogram taking the shape of withered arborization. Final diagnosis making depended on pathological examinations by lung biopsy. The positive rate of lung biopsy by endobronchial ultrasound is also high.