Treatment and prognosis of primary pulmonary lymphoma: A long‐term follow‐up study

Abstract

Primary pulmonary lymphoma (PPL) is a rare disease with not well‐defined optimal treatment. Outcomes and follow‐up are variable in published data. Objectives To define the outcome and optimal treatment strategies in PPL. Methods We reviewed the medical records of 49 patients with PPL treated in three Italian Hematological Institutions between 2002 and 2018. Results Thirty‐eight (77.5%) cases were indolent PPL, and 11 (22.5%) cases were aggressive PPL. The majority of patients were asymptomatic at diagnosis, early stages (stages IE‐IIE), normal serum LDH, no bone marrow involvement, and low or low‐intermediate risks of IPI. Local therapy ± immunotherapy or immuno‐chemotherapy was possible in 18/49 (37%) patients. Twenty‐eight (57%) patients were treated with immuno‐chemotherapy after biopsy. Waiting and watching were reported in 3 (6%) patients. Overall, the CR and ORR were 83.7% and 95.9%. With a median follow‐up of 62.5 months (range 0.8‐199 months), the estimated 5‐ and 10‐year OS rates were 85% and 72.3% for all patients, 89.2% and 80.3% for indolent PPL, and 70.7% and 47.1% for aggressive PPL. Aggressive PPL tended to have a high risk of progression in the first months (P = .056). No advantages were found for indolent PPL who received immuno‐chemotherapy or more conservative approaches. Conclusion Our studies confirm the epidemiological and favorable survival of patients with PPL, suggesting a very conservative approach, particularly in indolent subtypes.

Incidence, prognostic factors and clinical practice of Primary Pulmonary Lymphoma: A large population-based retrospective study

“…Different histological subtpye covers a wide spectrum of survival. A good 5-year OS and DSS in indolent PPL patients were entirely consistent with reported literature(Santopietro et al 2021). The worst survival was observed in T cell-NHL patients(OS = 7m, DSS = 4.5m), these patients were quickly deceased after diagnosis just as reported cases(Vahid et al 2007, Shi et al 2021.…”

Differential clinical and CT imaging features of pneumonic-type primary pulmonary lymphoma and pneumonia: a retrospective multicentre observational study

“…PPL and pneumonia are two conditions that require different treatment approaches. Yet, distinguishing PPL from pneumonia may be challenging, because they both present as consolidation on CT imaging, 12 13 which calls for accurate diagnosis. Our study compared the clinical and imaging features between two disease entities and developed a model using independent predictors.…”