Primary pulmonary lymphoma: imaging findings in 30 cases

Cozzi, Diletta; Dini, Carlotta Sorini; Mungai, Francesco; Puccini, Benedetta; Rigacci, Luigi; Miele, Vittorio

doi:10.1007/s11547-019-01091-z

Cited by 28 publications

(24 citation statements)

References 43 publications

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“…To our knowledge, CT is a very convenient and sensitive method for diagnosing lung lesions. However, PPL manifests itself in many different ways (21,(27)(28)(29)(30)(31), which makes it difficult to be distinguished from lung cancer, pneumonia, tuberculosis, diffuse interstitial lung disease, in our study, especially from lung cancer. In the DLBCL group, 6 out of the 7 cases are mass type, and they were misdiagnosed as lung cancer until pathologically confirmed.…”

Section: Discussionmentioning

confidence: 75%

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

Xie¹,

Zhang²,

Wu³

et al. 2020

Transl Cancer Res TCR

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Background: The retrospective study was mainly performed to determine the clinical symptoms and radiological characteristics of primary pulmonary lymphoma (PPL) to improve the recognition and diagnosis of the disease.Methods: Between June 2007 and June 2019, the clinical data and radiological images of the 16 patients with PPL confirmed by pathology were retrospectively analyzed.Results: Among the 16 patients with PPL (6 males and 10 females, aged 32 to 72 years, with a median age of 55.13 years), 9 patients were mucosa-associated lymphoid tissue lymphoma (MALT) and 7 patients were diffuse large B-cell lymphoma (DLBCL); all of the patients did not suffer from autoimmune disease [such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or Sjogren's syndrome (SSS)]; and 11 patients had a long-term smoking history from 10 to 40 years. The common clinical symptoms were as follows: chest discomfort (n=8), cough (n=10), chest pain (n=7), fever (n=6), apnea (n=1), fatigue (n=4) and weight loss (n=3), however, 6 cases did not show clear symptoms at the time of diagnosis. Blood tests revealed anemia (n=6), thrombocytopenia (n=2), lactate dehydrogenase (LDH) level (n=7), C-reactive protein (CRP) (n=9), erythrocyte sedimentation rate (ESR) (n=8) and no tumor-related indexes were detected abnormal.The chest radiological images showed a total of 8 cases with multiple masses, 2 cases with different types of nodes, 4 cases with patchy infiltration or consolidation shadow, with or without an air bronchogram, and 2 cases with a mixed manifestation. All the lesions were only involved in unilateral lung (13 right, 3 left), none of them located on bilateral lung fields. At the time of admission, the patients were misdiagnosed as lung cancer (n=9), pneumonia (n=5), tuberculosis (n=1), and diffuse interstitial lung disease (n=1). Then final pathological diagnosis was confirmed by surgery (n=9), percutaneous lung biopsy (n=5), and bronchoscopic biopsy (n=2).Conclusions: PPL is a rare disease, though clinical symptoms and radiological characteristics are not typical, they serve as significant clues for the diagnosis and differential diagnosis. Accurate diagnosis mainly depends on histopathological examination, however, conducting a retrospectively study could improve and enrich our knowledge to the disease and reduce inappropriate treatments.

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Section: Discussionmentioning

confidence: 75%

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

Xie¹,

Zhang²,

Wu³

et al. 2020

Transl Cancer Res TCR

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“…10 The most frequent pattern of pulmonary MALT lymphoma is consolidation pattern, which is similar to lobar pneumonia in CT imaging. 11 Misdiagnosis of lobar pneumonia as MALT lymphoma may result in overtreatment, and misdiagnosis of MALT lymphoma as lobar pneumonia may result in delayed chemotherapy or surgical treatment. 12 In the present study, we analyzed the CT imaging features and clinical characteristics of 26 patients with pulmonary MALT lymphoma and 36 patients with Patients with MALT lymphoma tend to present around the age of 60, but there are also reports of young patients, while the patients with lobar pneumonia are mostly young and middle-aged, and the age of the patients are relatively young.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of HRCT for the Differential Diagnosis of Pneumonia-Like Consolidation Pattern of Pulmonary MALT Lymphoma from Lobar Pneumonia

Qiu¹,

Chen²,

Zhang³

et al. 2021

CMAR

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Purpose: To assess the performance of high-resolution computed tomography (HRCT) in discriminating the consolidation pattern of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma from lobar pneumonia. Patients and Methods: This retrospective study comprised 26 patients with pathologically confirmed consolidation pattern of pulmonary MALT lymphoma (12 men and 14 women; mean age, 59.4±12.1 years) and 36 patients with lobar pneumonia confirmed by body fluids or respiratory secretion culture (16 men and 20 women; mean age, 41.8±26.3 years). Two radiologists independently evaluated the CT images. The effectiveness of these variables in distinguishing lobar pneumonia from MALT lymphoma was analyzed using logistic regression analysis. Results:The average age of lobar pneumonia patients was younger than that of MALT lymphoma patients (p=0.002). The respiratory symptom was more common in lobar pneumonia than MALT lymphoma (p=0.002). Signs of bronchiectasis within the consolidation and bulging of interlobar fissure occurred significantly more often in MALT lymphoma than pneumonia (69.2% vs 11.1%, p<0.0001; 46.2% vs 19.4%, p=0.024). We used the predictors with p<0.05 (age, respiratory symptoms, bronchiectasis, and bulging of interlobar fissure) to construct a logistic regression model. The area under curve (AUC), negative predictive value (NPV), positive predictive value (PPV), sensitivity, specificity, and accuracy were 0.891, 84.21%, 83.33%, 88.89%, 76.92%, and 83.87% for discriminating lobar pneumonia from MALT lymphoma. Conclusion: Middle-aged, presence of mild clinical symptoms, bronchiectasis and bulging of the interlobar fissure on chest CT images are potential markers to distinguish pulmonary MALT lymphoma from lobar pneumonia.

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“…Also, primary pulmonary lymphoma or secondary lesions from adenocarcinoma may manifest as GGO nodules or halo sign (Fig. 11) [87]. CT halo sign could be a manifestation of lepidic tumor cell growth along the alveolar wall in adenocarcinoma, peritumoral hemorrhage, or lymphangitic spread (if associated with interlobular septal thickening).…”

Section: Cancermentioning

confidence: 99%

Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

et al. 2021

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Primary pulmonary lymphoma: imaging findings in 30 cases

Cited by 28 publications

References 43 publications

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma

Evaluation of HRCT for the Differential Diagnosis of Pneumonia-Like Consolidation Pattern of Pulmonary MALT Lymphoma from Lobar Pneumonia

Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

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