Pulmonary MALT lymphoma is a rare disease that is easily misdiagnosed. The objective of this study was to improve the understanding of pulmonary MALT lymphoma for clinicians.
The computed tomography (CT) scans of 18 patients (13 males and 5 females), aged 41-70 years (mean=55.6 years), with histologically proven pulmonary MALT lymphoma were retrospectively reviewed by two radiologists, and pulmonary imaging findings were described. Correlations between the pulmonary abnormalities and histopathological findings in 13 patients were retrospectively reviewed.
Elementary lesions were characterized by masses or mass-like areas of consolidation (15/18), nodules (5/18), air bronchograms (16/18), airway dilatation (7/18), cavitation (5/18), airways passing through the lesion (8/18), CT angiogram signs (12/14) and vessels passing through the lesion (12/14). Additional findings included multiple cysts (n = 1), pleural effusion (n = 1) and atelectasis (n = 1). Pulmonary abnormalities were correlated with pathological appearance. Pathological examination confirmed lymphomatous infiltration with a bronchovascular distribution but no vessel or airway destruction, which appeared on CT as the vessels/airways passed through lesions naturally.
We herein demonstrated the imaging findings for 18 cases of pulmonary MALT lymphomas by analyzing the corresponding pathologies. We also discovered that vessels/airways could pass through pulmonary MALT lymphoma lesions, which may be helpful for diagnosis. This disease should be considered when chest CT imaging shows multiple/single masses or nodules or mass-like areas of consolidation together with vessels/airways passing through lesions.
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- Pulmonary mucosa-associated lymphoid tissue lymphoma revisited.Eur Respir J. 2016; 48: 1252
- Update in primary pulmonary lymphomas.Curr Opin Pulm Med. 2015; 21: 333-337
- Use of imaging in the management of malignant pleural mesothelioma.Clin Radiol. 2005; 60: 1237-1247
- Pathologic and clinical features of primary pulmonary extranodal marginal zone B-cell lymphoma of MALT type.Am J Surg Pathol. 2001; 25: 997-1008
- Clinical characteristics and prognostic factors of pulmonary MALT lymphoma.Eur Respir J. 2009; 34: 1408-1416
- Primary pulmonary lymphoma.Eur Respir J. 2002; 20: 750-762
- Marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: imaging findings in 21 patients.Chest. 2008; 133: 433-440
- Pulmonary MALT lymphoma: imaging findings in 24 cases.Eur Radiol. 2000; 10: 1932-1938
- Lymphoma of pulmonary mucosa-associated lymphoid tissue: CT scan findings and pathological correlations.Eur Respir J. 1999; 14: 423-429
- Primary endobronchial marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: CT findings in 7 patients.Korean J Radiol. 2013; 14: 366-374
- Pulmonary mucosa-associated lymphoid tissue lymphoma: (18)F-FDG PET/CT and CT findings in 28 patients.Br J Radiol. 2017; 90:20170311
- Pulmonary MALT lymphoma has variable features on CT.Sci Rep. 2019; 9: 8657
- WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues.4rth ed. IARC Lyon, 2008
- Fleischner Society: glossary of terms for thoracic imaging.Radiology. 2008; 246: 697-722
- Bronchus- and nasal-associated lymphoid tissues.Immunol Rev. 2005; 206: 22-31
- Lymphoproliferative neoplasms of the lung: a review.Arch Pathol Lab Med. 2013; 137: 382-391
- Primary pulmonary lymphoid lesions: radiologic and pathologic findings.Radiogr Rev Publ Radiol Soc N Am Inc. 2016; 36: 53-70
- Primary pulmonary lymphomas.Adv Anat Pathol. 2015; 22: 355-375
- A retrospective international study on primary extranodal marginal zone lymphoma of the lung (BALT lymphoma) on behalf of international extranodal lymphoma study group (IELSG).Hematol Oncol. 2016; 34: 177-183
- Malignant lymphoma in primary Sjogren's syndrome: an update on the pathogenesis and treatment.Semin Arthritis Rheum. 2013; 43: 178-186
- Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph consortium.Blood. 2008; 111: 4029-4038
- Malignant and benign lymphoid lesions of the lung.Ann Diagn Pathol. 2004; 8: 167-187
- Pulmonary parenchymal involvement of low-grade lymphoproliferative disorders.J Comput Assist Tomogr. 2005; 29: 825-830
- Bronchial-associated lymphoid tissue lymphoma: a clinical study of a rare disease.Eur J Cancer. 2004; 40: 1320-1326
- B-cell lymphoma of bronchus-associated lymphoid tissue (BALT): CT features in 10 patients.J Comput Assist Tomogr. 2000; 24: 30-34
- Extranodal marginal zone B-cell lymphoma of the lung in Sjogren's syndrome patients: reappraisal of clinical, radiological, and pathology findings.Respir Med. 2007; 101: 84-92
- Primary pulmonary lymphoma: a retrospective analysis of 27 cases in a single tertiary hospital.Am J Med Sci. 2019; 357: 316-322
- CT angiogram sign: incidence and significance in lobar consolidations evaluated by contrast-enhanced CT.AJR Am J Roentgenol. 1998; 170: 719-721
- Significance of imaging and clinical features in the differentiation between primary and secondary pulmonary lymphoma.Oncol Lett. 2017; 14: 6224-6230
- CT “angiogram sign” in primary pulmonary lymphoma.J Comput Assist Tomogr. 1992; 16: 829-831
Published online: March 11, 2022
Accepted: February 24, 2022
Received: March 4, 2021
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.