• Primary lung lymphoma
• Surgery
• Survival
• Thoracic

• Primary pulmonary lymphoma diagnosis
• anaemia of inflammation
• hyperferritinaemia
• monocytosis
• primary pulmonary lymphoma

• COX regression analyses
• Lymphoma, large B cell, diffuse
• SEER
• nomogram
• non-Hodgkin's lymphoma
• prognosis
• pulmonary
• therapy

• Humans
• Lymphoma, Large B-Cell, Diffuse/therapy
• Lymphoma, Large B-Cell, Diffuse/diagnosis
• Lymphoma, Large B-Cell, Diffuse/epidemiology
• Lymphoma, Large B-Cell, Diffuse/mortality
• Female
• Male
• Middle Aged
• Aged
• Prognosis
• Lung Neoplasms/therapy
• Lung Neoplasms/epidemiology
• Lung Neoplasms/pathology
• Lung Neoplasms/diagnosis
• Lung Neoplasms/mortality
• Nomograms
• Risk Factors
• SEER Program
• Adult
• Aged, 80 and over

• follicular lymphoma
• non-Hodgkin’s lymphoma
• operative resection
• primary pulmonary lymphoma
• thoracotomy

• acanthosis nigricans
• diffuse large b cell lymphoma (dlbcl)
• non-hodgkin's lymphoma
• paraneoplastic syndrome
• primary pulmonary lymphoma

• Case report
• Extranodal natural killer/T cell lymphoma
• Nasal type
• pneumonia

• hepatosplenomegaly
• non-resolving consolidation
• sarcoidosis

• Haematology (incl blood transfusion)
• Lung cancer (oncology)
• Medical education
• Pneumonia (respiratory medicine)
• Respiratory system

• Humans
• Lymphomatoid Granulomatosis/diagnosis
• Lymphomatoid Granulomatosis/drug therapy
• Male
• Diagnosis, Differential
• Adult
• Pneumonia, Pneumocystis/diagnosis
• Pneumonia, Pneumocystis/drug therapy
• Pneumocystis carinii/isolation & purification
• Tomography, X-Ray Computed
• Lung/diagnostic imaging
• Lung/pathology

• Humans
• Lung Neoplasms/diagnosis
• Lung Neoplasms/diagnostic imaging
• Lung Neoplasms/pathology
• Diagnosis, Differential
• Small Cell Lung Carcinoma/diagnosis
• Small Cell Lung Carcinoma/diagnostic imaging
• Bronchial Neoplasms/diagnosis
• Bronchial Neoplasms/diagnostic imaging
• Bronchial Neoplasms/pathology
• Male
• Bronchoscopy
• Lymphoma, B-Cell/diagnosis
• Lymphoma, B-Cell/diagnostic imaging
• Lymphoma, B-Cell/pathology
• Aged
• Middle Aged

• Angio-TDM thoracique
• Artériographie bronchique
• Bronchial arteriography
• Cancer pulmonaire
• Chest CT scan
• Hémoptysie grave
• Lung neoplasms
• Severe hemoptysis

• Humans
• Hemoptysis/diagnosis
• Hemoptysis/etiology
• Hemoptysis/therapy
• Embolization, Therapeutic/adverse effects
• Bronchoscopy/adverse effects
• Bronchi
• Hematology

• Clinicopathological characteristics
• Computed tomography
• Lung biopsy
• Peripheral T-cell lymphoma
• Pulmonary involvement

• Humans
• Adult
• Middle Aged
• Aged
• Aged, 80 and over
• Lymphoma, T-Cell, Peripheral/pathology
• Epstein-Barr Virus Infections/pathology
• Retrospective Studies
• Herpesvirus 4, Human/genetics
• Biopsy
• Lung/diagnostic imaging
• Lung/pathology

• Diagnosis
• Machine learning
• Pulmonary MALT lymphoma
• Radiomics

• Humans
• Radiomics
• Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
• Cluster Analysis
• Tomography, X-Ray Computed
• Lung

• Lung cancer (oncology)
• Pneumonia (respiratory medicine)

• Humans
• Male
• Lymphoma, B-Cell, Marginal Zone/diagnosis
• Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
• Lung/pathology
• Pneumonia/pathology
• Bronchial Neoplasms/pathology
• Radiography

• Low-staged (IE/IIE)
• Pulmonary MALT lymphoma
• Survival
• Treatment modalities

• 21Y11913400 Science and Technology Commission of Shanghai Municipality
• 82272943 National Natural Science Foundation of China

• haemoptysis
• invasive aspergillosis
• pulmonary maltoma
• tuberculosis associated obstructive pulmonary disease
• upper lobe lobectomy

• Interstitial lung disease
• Malignant and Benign haematology
• Pathology
• Radiology

• Male
• Humans
• Lymphomatoid Granulomatosis/complications
• Lymphomatoid Granulomatosis/diagnosis
• Lymphomatoid Granulomatosis/drug therapy
• Epstein-Barr Virus Infections/complications
• Herpesvirus 4, Human
• Lung/diagnostic imaging
• Lung/pathology
• Respiratory Distress Syndrome/complications
• Respiratory Insufficiency/complications

• lung consolidation
• lymphoma
• pulmonary mucosa‐associated lymphoid tissue

• lung neoplasms
• lymphoma
• primary lung lymphoma

• primary pulmonary lymphoma
• pneumonia
• computed tomography
• radiomics
• differentiation

• Humans
• Retrospective Studies
• Pneumonia/diagnostic imaging
• Analysis of Variance
• Tomography, X-Ray Computed
• Lymphoma/diagnostic imaging

Mucosa-associated lymphoid tissue (MALT) lymphoma originates in the marginal zone of lymphoid tissue. lung is one of the most frequent non-gastrointestinal organs involved, here known as bronchus-associated lymphoid tissue (BALT) lymphoma. BALT lymphoma of unknown etiology, and most patients are asymptomatic. The treatment of BALT lymphoma is controversial.

A 55-year-old man admitted to hospital had a three-month history of progressively coughing up yellow sputum, chest stuffiness, and shortness of breath. Fiberoptic bronchoscopy revealed mucosal visible beaded bumps 4 cm from the tracheal carina at 9 o 'clock and 3 o 'clock, the right main bronchus, and the right upper lobe bronchus. Biopsy specimens showed MALT lymphoma. Computed tomography virtual bronchoscopy (CTVB) showed uneven main bronchial wall thickening and multiple nodular protrusion. BALT lymphoma stage IE was diagnosed after a staging examination. We treated the patient with radiotherapy (RT) alone. A total dose of 30.6 Gy/17 f/25 d was given. The patient had no obvious adverse reactions during RT. The CTVB was repeated after RT and showed that the right side of the trachea was slightly thickened. CTVB was repeated 1.5 mo after RT and again showed that the right side of the trachea was slightly thickened. Annual CTVB showed no signs of recurrence. The patient now has no symptoms.

BALT lymphoma is an uncommon disease and shows good prognosis. The treatment of BALT lymphoma is controversial. In recent years, less invasive diagnostic and therapeutic approaches have been emerging. RT was effective and safe in our case. The use of CTVB could provide a noninvasive, repeatable, and accurate method in diagnosis and follow-up.

• Mucosa-associated lymphoid tissue lymphoma
• Computed tomography virtual bronchoscopy
• Radiotherapy
• Prognosis
• Case Report

The occurrence of primary pulmonary lymphoma (PPL) as a secondary malignancy in patients diagnosed with chronic myeloid leukemia (CML) is extremely rare. As the clinical manifestations are atypical, most patients with PPL tend to be misdiagnosed with pneumonia. When the radiographic features of PPL and pulmonary infection overlap, clinicians can be confused about the diagnosis. Here, we report the first case of coexistence of PPL and opportunistic infections in a patient with CML in chronic phase (CML-CP).

A 55-year-old woman presented with three weeks of hemorrhage of the oral mucosa at the Department of Hematology. After undergoing various examinations, she was diagnosed with CML-CP and was started on imatinib (400 mg/daily). Due to sudden respiratory distress, the patient was admitted to the respiratory intensive care unit 11 months later. Chest computed tomography (CT) revealed ground-glass opacities, patchy shadows, and multiple nodules in both lungs and enlarged mediastinal lymph nodes. The combination of biapenem and voriconazole antibiotic treatments was effective. The patient’s respiratory distress was relieved, but there was intermittent coughing. In the following time, the patient developed a fever, and the imaging findings indicated progression of the disease in both lungs. Bronchoalveolar lavage (BAL) identified pathogens of multiple opportunistic infections. The coexistence of lymphomatoid granulomatosis (LYG) was not confirmed in this patient until a second CT-guided biopsy was performed. Ultimately, the patient underwent chemotherapy in time and is currently alive today.

When the patient’s recurrent respiratory symptoms and imaging findings do not coincide, secondary tumors should be considered in addition to infection as a diagnosis. In these cases, multiple pathological tissue biopsies should be performed.

• CT scan
• Dyspnea
• Lymphoma
• MalToma
• Primary
• Pulmonary

• Chinese patients
• FDG (18F-fluorodeoxyglucose)-PET/CT
• metabolic characteristic
• primary pulmonary lymphoma (PPL)
• prospective

To date, there is no treatment consensus on mucosa-associated lymphoid tissue (MALT) derived primary pulmonary lymphoma (PPL).

We identified patients with early-stage MALT-type PPL from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program database. The patients were divided into four groups according to treatment modalities: None of surgery or chemotherapy (None) group, Surgery alone group, Chemotherapy alone (Chemo alone) group, and Surgery plus chemotherapy (Surgery + chemo) group. Overall survival (OS) and cancer-specific survival (CSS) were study endpoints. We performed Cox regression analyses, propensity score-matched analyses (PSM) and Kaplan-Meier (KM) survival curves to compare the survival among different groups.

A total of 953 patients were included in our analysis with 302, 403, 175, and 73 cases in the None, Surgery alone, Chemo alone, and Surgery + chemo groups, respectively. In this cohort, the estimated 3-year, 5-year and 10-year OS rates were 86.95%, 78.91%, and 55.89%, respectively. Meanwhile, the estimated 3-year, 5-year and 10-year CSS rates were 96.71%, 93.73%, and 86.84%, respectively. Multivariate Cox regression analyses demonstrated that increasing age, tumors located in the lower lobe, and stage II were significant predictors of poorer OS while increasing age and tumors located in the bilateral lungs were associated with lower CSS. After PSM analyses, the KM survival curves showed no significant differences in OS or CSS among the four groups.

Early-stage MALT-type PPL is indolent in nature. Neither surgery, chemotherapy nor a combination of surgery and chemotherapy can improve OS and CSS, suggesting that “watch and wait” may be a reasonable alternative.

• IgG4
• multiple lung cysts
• pulmonary MALT lymphoma

• Blotting, Southern
• Gene Rearrangement
• Humans
• Immunoglobulin G/metabolism
• Lung/pathology
• Lymphoma, B-Cell, Marginal Zone/pathology

Primary pulmonary lymphoma (PPL) is a rare clonal lymphoproliferative lung disease. The present study analyzes the clinical features, imaging data, pathologic characteristics, treatment, and prognosis of PPL patients, with the aim to discuss the appropriate diagnosis and therapy of PPL patients in thoracic surgery.

We performed a retrospective analysis on 36 patients with PPL confirmed by postoperative pathology between 2006 and 2020. We divided the patients into low-stage (IE) and high-stage (IIE) groups using modified Ann Arbor staging. The clinical manifestations, imaging findings, treatment modalities, and outcomes were evaluated.

The female to male ratio was 1.57:1 and the median age was 55 (31–69) years old. The majority of the patients had stage IE disease (75%; 27 of 36) and 9 patients had stage IIE disease. Patients with advancing stage were more likely to have respiratory symptoms. The imaging findings presented solid nodule or mass, pneumonia-like consolidative pattern, ground-glass opacity, and mixed pattern. There were 31 cases of mucosa-associated lymphoid tissue lymphoma (MALT), 2 diffuse large B-cell lymphoma (DLBCL), 2 nodular sclerosing Hodgkin’s lymphoma, and 1 marginal zone B-cell lymphoma. Two patients were diagnosed with PPL and non-small cell lung cancer (NSCLC) synchronously (one AIS and MIS and one lung adenocarcinoma). All the patients received surgery. Nine patients received adjuvant therapy after surgery (five radiotherapy, two chemotherapy, and two chemoradiotherapy). Thirty-four patients had a median follow-up time of 31 months (follow-up range: 7–152 months). Of the 34 patients, 1 patient died of liver metastases and 1 patient died of intestinal metastases.

Our retrospective analysis suggested that most PPLs were indolent and had favorable prognosis, but the discrimination of PPL with other lung diseases was difficult. Preoperative biopsy and intraoperative frozen section examination might help in the surgical choice. Limited lung resection was enough for peripherally localized PPL.

• CT
• MALT
• PET
• Subsolid
• lymphoma
• nodule

Objective: This study aimed at to raise the awareness understanding of primary pulmonary lymphoma (PPL) by analyzing the clinical manifestation, imaging, pathology, diagnosis, treatment, and prognostic features of 50 cases of PPL. Methods: The study of 50 individuals with PPL diagnosed at the First affiliated hospital of Nanchang university between January 2009 and December 2019 was performed. Results: Overall, 27 males and 23 females were enrolled, with an average age of 57.6 ± 15.6 years. The primary symptoms included, cough (n = 37), expectoration (n = 25), sputum with blood (n = 12), and chest pain (n = 12). Two individuals had Hodgkin's lymphoma and 48 patients had non-Hodgkin's lymphoma (NHL). We divided the NHL cases into mucosa-associated lymphoid tissue lymphoma (MALT) (n = 21), diffuse large B-cell lymphoma (n = 12), small lymphocytic lymphoma (n = 2), mantle B-cell lymphoma (n = 2), follicular lymphoma (n = 1), B-cell lymphoma without further classification (n = 8), and T-cell lymphoma (n = 2). The imaging findings revealed that unilateral lung involvement was more common among the patients. The longest follow-up duration up to December 2019 was 123 months with 40 surviving patients. The 5-year overall survival and progression-free survival were 46.7% and 44.4%, respectively. Age was an independent predictive factor for the 5-year survival (hazard ratio, 8.900; P = .038), (P < .05). Conclusion: PPL is a uncommon disease with atypical clinical manifestations and is often misdiagnosed. Immunohistochemistry is currently the standard used in pathologic evaluation of PPL. MALT prognosis is better in contrast with other kinds of PPL. Surgery or radiotherapy can be considered in patients with limited lesions, and chemotherapy is the first treatment option for diffuse lesions. Age of ≥ 60 years was reported as an independent adverse predictive factor.

• clinical characteristic
• literature review
• pathological characteristic
• primary pulmonary lymphoma
• retrospective study

• adenocarcinoma with lepidic pattern
• bronchoscopy
• lymphadenopathy
• nonresolving pneumonia
• pneumonia

Treatment of mucosa-associated lymphoid tissue (MALT) lymphoma has recently received considerable attention. Here, we report a case of large esophageal MALT lymphoma that was successfully en bloc resected using endoscopic submucosal dissection (ESD). A 77-year-old woman was admitted to our hospital with progressive dysphagia for more than 2 months. Upper gastrointestinal endoscopy revealed a large rounded submucosal mass covered by normal mucosa, located at the lower esophagus. Endoscopic ultrasonography (EUS) showed a well-demarcated hypoechoic mass chiefly located in the esophageal wall, but the layers of the esophageal wall were not clear. ESD was performed for diagnostic and treatment purposes. No complications occurred during or after ESD. The resected specimen measured 4.3 cm × 2.8 cm × 1.5 cm. The histologic findings were diagnostic of esophageal MALT lymphoma. Infiltration of neoplastic cells in the lateral margins of the resected specimen was not observed. However, vertical margins showed an R1 situation and mild damage to the muscularis propria. After 3 months, her dysphagia disappeared. Additional radiation therapy was then administered. After 5 months, the patient was still under surveillance and free of recurrent disease. Resection with ESD of such a large mass of MALT in the esophageal region has rarely been reported before in the literature.

• endoscopic submucosal dissection
• esophagus
• mucosa-associated lymphoid tissue lymphoma
• pathology
• treatment

Background: We aimed to study the clinical features and survival outcomes of patients with early-stage primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma who underwent surgery.

Methods: This is a retrospective, single-center study including 32 patients with early-stage primary pulmonary MALT lymphoma. Univariate and multivariate Cox analyses were performed to select independent prognostic factors. The overall survival (OS) was analyzed by the Kaplan-Meier method and was compared with the log-rank test.

Results: Among the 32 patients included, there were 16 men (50.0%) and 16 women (50.0%). The average age was 59.2 years old. Ten patients had non-specific clinical symptoms including cough, expectoration, and chest pain, and four patients had B symptoms. CT images are not specific and can be shown as peripheral, central, solid, and ground glass but more peripheral (93.8%) and solid (75.0%). In prognostic analysis, univariate analysis showed that tumor stage and size were associated with relapse-free survival (RFS) and OS [hazard ratio (HR) = 1.105, 95% CI: 1.021–1.197, P = 0.011; HR = 1.211, 95% CI: 1.158–1.968, P = 0.003, respectively]. It seems to indicate that higher stage and larger size indicate a worse prognosis, but we could not find statistically significant predictors in multivariate analysis. Sublobectomy was performed in 21 (65.6) cases, lobectomy was performed in the other 11 (34.4) cases, both of them can achieve good prognosis (5-year RFS and OS are both 100%), and there is no significant difference between them.

Conclusions: The clinical manifestation of early-stage primary pulmonary MALT lymphoma is not significantly specific, and surgical resection is an effective treatment.

• MALT
• prognosis
• pulmonary
• surgical treatment
• thoracic disease

• AER: absolute excess risk
• Abbreviations
• CI: confidence interval
• DLBCL
• DLBCL: diffuse large B-cell lymphoma
• Epidemiology and end results database
• GI tract: gastrointestinal tract
• HR: hazard ratio
• O/E: observed-to-expected
• OS: overall survival
• Primary extranodal sites
• Prognosis
• SEER: surveillance
• SIR: standardized incidence ratio
• SMNs: secondary malignant neoplasms
• Second malignant neoplasms
• Standardized incidence ratio

• Anaplastic lymphoma kinase
• Case report
• Differential diagnosis
• Lung infection
• Lungs
• Primary anaplastic large cell lymphoma

• Lung cancer; CT; benign pulmonary tumors; percutaneous transthoracic biopsy

Mucosa associated lymphoid tissue (MALT) is a type of B-cell lymphoma that is commonly observed in the gastrointestinal site, most frequently occurring in the stomach. However, the incidence of this type of lymphoma in the respiratory tract is very uncommon. We report a case of this rare clinical entity in a patient who presented with non-symptomatology and was diagnosed with pulmonary MALT lymphoma (pMALToma).

• Extranodal marginal zone lymphoma
• Lymphoma
• Pulmonary maltoma

The group of B-cell lymphomas primarily involving the lung encompasses different histological entities with distinct biological aspects, while sharing some clinical and radiological features related to their common anatomic site of occurrence. Recent molecular advances in the molecular genetics of these lesions have substantially improved of our understanding of the mechanisms of lymphomagenesis, adding novel information to histology in order to better characterize and manage these diseases. This review summarizes the available clinical, radiological, pathological, and molecular data on primary pulmonary B-cell lymphomas, discusses the mechanisms of lymphomagenesis, and highlights the role of a multi-disciplinary management in overcoming the diagnostic and therapeutic challenges in this setting.

Primary pulmonary B-cell lymphomas (PP-BCLs) comprise a group of extranodal non-Hodgkin lymphomas of B-cell origin, which primarily affect the lung without evidence of extrapulmonary disease at the time of diagnosis and up to 3 months afterwards. Primary lymphoid proliferations of the lung are most often of B-cell lineage, and include three major entities with different clinical, morphological, and molecular features: primary pulmonary marginal zone lymphoma of mucosa-associated lymphoid tissue (PP-MZL, or MALT lymphoma), primary pulmonary diffuse large B cell lymphoma (PP-DLBCL), and lymphomatoid granulomatosis (LYG). Less common entities include primary effusion B-cell lymphoma (PEL) and intravascular large B cell lymphoma (IVLBCL). A proper workup requires a multidisciplinary approach, including radiologists, pneumologists, thoracic surgeons, pathologists, hemato-oncologists, and radiation oncologists, in order to achieve a correct diagnosis and risk assessment. Aim of this review is to analyze and outline the clinical and pathological features of the most frequent PP-BCLs, and to critically analyze the major issues in their diagnosis and management.

• BALT
• MALT lymphoma
• diffuse large B-cell lymphoma
• intravascular large B-cell lymphoma
• lymphomatoid granulomatosis
• primary effusion lymphoma
• pulmonary B-cell lymphoma

An 81-year-old male presented with a background history of progressive shortness of breath for 3 years with recent worsening in the past 6 months. Clinicoradiological investigations were consistent with a nonresolving consolidation involving predominantly right lung. This clinicopathologic conference discusses the differential diagnoses of pneumonia of long-standing duration and their management options.

• Mucosa-associated lymphoid tissue lymphoma
• nonresolving consolidation
• pulmonary

• aggressive B-NHL
• indolent B-NHL
• lymphoproliferative diseases
• non-Hodgkin's lymphoma

Primary pulmonary lymphoma is an uncommon disease, and extranodal marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT) is the most common type of pulmonary lymphoma. The most frequent pattern observed in chest computed tomography (CT) is consolidation, followed by nodules and mass. The differentiation of pulmonary MALT lymphoma from other lung diseases is critical for disease management and treatment. However, pulmonary MALT lymphoma with isolated endobronchial manifestation has seldomly been reported. Here, we report a case of an elderly woman who presented with a four‐month history of cough, dyspnoea, and haemoptysis. Chest CT scan revealed left main bronchus narrowing without lung parenchymal lesion. Bronchoscopic examination was performed, and the diagnosis of primary pulmonary MALT lymphoma with isolated endobronchial involvement was made. She has been successfully treated with rituximab.

• Bronchoscopy
• MALT lymphoma
• primary pulmonary lymphoma