Surgical resection for the diagnosis and treatment of primary pulmonary mucosa-associated lymphoid tissue lymphoma / 中国肿瘤临床

ABSTRACT

Objective:To discuss the clinical and imaging features as well as the treatment and prognosis of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods:We retrospectively analyzed the clinical, imaging, and follow-up data of 13 patients with pulmonary MALT lymphoma in the Chinese PLA General Hospital from April 2000 to July 2012. Results:Of the 13 patients with pulmonary MALT lymphoma, 8 were male and 5 were female (1.61 ratio). The age of onset varies from 21 years to 67 years, and the median age is 59 years. The major clinical manifestations include chest discomfort in 6 cases, cough in 2 cases, fever in 2 cases, and chest pain in 1 case. Two cases had no observable discomfort. One patient suffered from Sj?gren's syndrome. The chest CT of the patients showed pulmonary consolidation with air bronchogram in 3 cases, patchy shadows in 3 cases, mass shadow in 4 cases, and ground-glass opacities in 4 cases. In addition, 10 cases showed bilateral pulmonary multiple changes, 4 showed mediastinal lymph node enlargement, and 1 showed pleural effusion. Operation was performed on 6 patients, 3 of which were given postoperative adjuvant chemotherapy. Four patients underwent chemotherapy involving the CHOP or R-CHOP regimen, whereas three patients received symptomatic and supportive treatment only. One case was lost to follow-up. The follow-up period ranged from 1 year to 11 years. In one patient, the disease progressed four years after the diagnosis, and the patient died after 11 years. One patient died from the side effects of chemotherapy. The remaining 10 cases were still alive and did not show any progression of the disease. Conclusion:The clinical feature of pulmonary MALT lymphoma is not typical. Thus, imaging techniques cannot detect specific changes. Surgical resection is vital in the diagnosis and treatment of this disease because it can help provide a clear diagnosis, particularly to patients with limited lesions and from which specimens could not be obtained using conventional methods. Moreover, the prognosis of this treatment is generally good.