Multiple Organ Mucosa-Associated Lymphoid Tissue Lymphoma Presenting with Lymphangitic Pattern of Spread in the Lung

Abstract

W e report a case of mucosa-associated lymphoid tissue (MALT) lymphoma involving multiple organs including the lung. A 78-year-old woman presented with a left asymptomatic submandibular mass that had been present for 2 months. Her chest radiograph and computed tomographic (CT) scan revealed multiple micronodules and thickening of bronchovascular bundles, suggestive of lung diseases with lymphangitic spread. Lung histology showed extranodal marginal zone B-cell lymphoma of MALT type, and CT scans and bone marrow aspiration revealed the involvement of the submandibular gland, abdominal lymph nodes, and bone marrow. Treatment of rituximab alone led to a partial response of the tumors. Although MALT lymphomas tend to be localized, multiple-organ MALT lymphoma should be considered in the differential diagnosis of lung diseases with a lymphangitic pattern. DISCUSSIONMALT lymphomas are low-grade lymphomas. They derive from marginal zone B cells that surround the mantle zone and germinal center and are classified as extranodal marginal zone B-cell lymphoma of MALT type, a distinct subgroup of non-Hodgkin's lymphomas. 2 MALT lymphomas tend to remain localized, but involvement of multiple muco-

CT, MRI, and 18F-FDG PET/CT Findings in Untreated Pulmonary and Hepatic B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) Over a Five-Year Period

“…11–13 Rarely, MALT lymphoma can manifest as mosaic or lymphangitic spread pattern in the lung. 14,15 In this case, the pulmonary MALT lymphoma showed bilateral peripheral consolidations, and diffuse micronodules with lymphangitic distribution. CT or MRI features of hepatic MALT lymphoma are rarely described before.…”