Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Primary pulmonary lymphoma (Extranodal marginal zone B cell lymphoma)
- Radiologic Findings
- Chest PA shows consolidation persisted despite antibiotic therapy. Contrast-enhanced chest CT confirms right middle lobe consolidation without remarkable enhancement. However, there was no remarkable mediastinal and cervical lymph node enlargement. Sequentially, this patient underwent PET/CT and CT guided gun needle biopsy to rule out the malignancy. PET/CT image shows increased FDG uptake only at the right middle lobe consolidation.
- Brief Review
- Primary pulmonary lymphoma can be defined as lymphoma that is initially localized in lung tissue. At the diagnosis, patients` age ranges from 50 to 60 years old. Most of primary pulmonary lymphoma is low-grade B-cell tumors. Grossly, low-grade B-cell lymphoma appears as a well-circumscribed nodule or a focal area of parenchymal consolidation. Underlying lung structures as airways and vessels are often recognizable. The second most common primary tumor as lymphomatoid granulomatosis is high-grade and may have either a B- or T-cell phenotype, and be commonly associated with necrosis. Typical CT findings of primary pulmonary lymphoma include solitary or multifocal nodules or masses and areas of airspace consolidations with an air bronchogram. Because the bronchi and membranous bronchioles tend to be unaffected, an air bronchogram can be commonly noted. Less common CT findings includes interlobular septal thickening, centrilobular nodules, and bronchial wall thickening. In the treatment, surgical resection can be recommended for localized diseases. And, 5-year survival rate is greater than 80%.
- References
- 1. Addis BJ, Hyjek E, Isaacson PG. Primary pulmonary lymphoma: A re-appraisal of its histogenesis and its relationship to pseudolymphoma and lymphoid interstitial pneumonia. Histopathology. 1988;13:1-17
2. Bae YA, Lee KS, Han J, Ko YH, Kim BT, Chung MJ, Kim TS. Marginal zone b-cell lymphoma of bronchus-associated lymphoid tissue: Imaging findings in 21 patients. Chest. 2008;133:433-440
3. Ooi GC, Chim CS, Lie AK, Tsang KW. Computed tomography features of primary pulmonary non-hodgkin's lymphoma. Clinical radiology. 1999;54:438-443
- Keywords
- Lung, Lymphproliferative disorder, Lymphoma,