Discussion
Diagnosis With Brief Discussion
- Diagnosis
- MALT lymphoma
- Radiologic Findings
- Fig 1. Chest PA shows focal increased opacity in the right upper lung field.
Fig 2-6. Chest CT images demonstrate an ill-defined mass-like consolidation with air-bronchogram in the right upper lobe. Enhanced CT shows a relatively homogeneously enhancing consolidation. Former CT reveals that the size of the consolidation has slowly increased over the span of nine years. Percutaneous needle biopsy revealed Mucosa associated lymphoid tissue (MALT) lymphoma.
- Brief Review
- MALT lymphoma is a monoclonal lymphoid proliferation arising from a B-cell progenitor within bronchial associated lymphoid tissue (BALT), and is classified as low-grade marginal zone B-cell lymphoma. Radiography shows nodules, masses, and/or consolidation. CT shows multiple nodules, masses, and/or nodular/mass-like areas of ground-glass attenuation or consolidation, which tend to be in a bronchovascular distribution and often show air bronchogram. Halo of ground-glass shadowing or peribronchovascular thickening at tumor margins, and discrete patches of ground glass shadowing, positive angiogram sign on contrast enhanced CT can also be seen. Slowly progressive pulmonary consolidation in conjunction with a supportive history of autoimmune disease or lymphoma in another mucosal site should strongly suggest the diagnosis of MALT lymphoma. MALT lymphoma lesions are hypermetabolic at PET/CT approximately half of the time.
Treatment is usually with chemotherapy or immunotherapy (rituximab). Surgery and radiation therapy are options available for localized disease. The prognosis is good, with 5- and 10-year survival rates ranging from 84% to 88%.
- References
- 1. Sirajuddin A, Raparia K, Lewis VA et al. Primary pulmonary lymphoid lesions: Radiologic pathologic findings. Radiographics. 2016 Jan-Feb;36(1):53-70.
2. O Donnel, PG, Jackson SA, Tung KT, Hassan B, Wilkins B, Mead GM. Radiological appreance of lymphomas arising from Mucosa-associated lymphoid tissue (MALT) in the lung. Clinical Radiology 1998;53:258-263.
3. King LJ, Padley SP, Wotherspoon AC, Nicholson AG. Pulmonary MALT lymphoma: imaging findings in 24 cases. Eur Radiol 2000;10(12):1932-8
- Please refer to
- Case 851 Case 1032 Case 1049 Case 1071
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- Keywords
- Lung, Neoplasm_Malignant,