대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesArchive of Old Cases

Case No : 1212 Date 2021-01-12

  • Courtesy of Sung Hyun Yoon / Bundang Seoul National University Hospital
  • Age/Sex 58 / M
  • Chief ComplaintIncidental finding
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
MALT lymphoma
Radiologic Findings
Fig 1-4. Contrast-enhanced CT image shows a paravertebral posterior mediastinal mass. The elongated mass shows homogeneous enhancement (average HU 77).
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
Keywords
posterior mediastinum, MALT lymphoma,

No. of Applicants : 99

▶ Correct Answer : 18/99,  18.2%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
  • - Centre Hospitalier Boulogne-sur-Mer , France BENJAMIN DAMAREY
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Hamamatsu University Hospital , Japan HAYATO NOZAWA
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - Gifu University Hospital , Japan Yo Kaneko
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - , Saudi Arabia RAWAN AHMED ALJEFRI
  • - Kyeongpook National University Hospital , Korea (South) PARK BYUNG GEON
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - , Japan KAZUMA TERAUCHI
  • - Tokyo Metropolitan Bokutoh Hospital , Japan TOMOKI WADA
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - , Korea (South) WONJU HONG
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
▶ Correct Answer as Differential Diagnosis : 34/99,  34.3%
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - TWMU Medical Center East , Japan MASAFUMI KAIUME
  • - Ulsan University Hospital , Korea (South) SOYEOUN LIM
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - National cancer center hospital east , Japan SHIOTO ODA
  • - Chonbuk National University Hospital , Korea (South) HYEJIN YANG
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - IRSA LA ROCHELLE , France JEAN LUC BIGOT
  • - Ichinomiya Nishi Hospital , Japan CHIHIRO KIGUCHI
  • - Samsung Medical Center , Korea (South) CHOHEE KIM
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - Kurashiki Central Hospital , Japan HISATAKA ITO
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - , Korea (South) HYEWON CHOI
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - , Korea (South) PARK JONGMIN
  • - Chungbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - , Korea (South) EUNJIN LEE
  • - Osaka City General Hospital , Japan SHU MATSUSHITA
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - , Japan NAOMI YUASA
  • - Ajou University Hospital , Korea (South) HYERIN KIM
  • - Seoul Veterans Hospital , Korea (South) JANG SEONG WON
  • - , Japan HIROAKI ARAKAWA
  • - Other , Korea (South) KYU-CHONG LEE
  • - Kitano Hospital , Japan SATOSHI IKEDA
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Private sector , Greece VASILIOS TZILAS
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - Chonnam National University Hwasun Hospital , Korea (South) WONGI JEONG
▶ Semi-Correct Answer : 1/99,  1.0%
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
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