Diagnosis and treatment of pulmonary mucosa-associated lymphoid tissue lymphoma.

BACKGROUND: Primary non-Hodgkin's lymphoma in lung is very rare, and the most common among them is mucosa-associated lymphoid tissue lymphoma (MALToma), whose clinical features and laboratory characteristics are poorly defined, making diagnosis difficult. The purpose of this study was to study the diagnosis and treatment of pulmonary MALToma. METHODS: The clinical data of 12 patients treated for MALToma between August 1992 and December 2005 were analyzed. RESULTS: No specific symptoms or signs, or results of bronchoscopy, ultrasonagraphy or bone marrow examination could be found in the 12 patients. Only radiography was useful in diagnosis, though the final diagnosis of all the patients was based on histology and immunohistochemistry. Two patients also had gastric MALToma. Operations were performed on 6 patients, including 5 radical operations and 1 partial resection: 4 patients also received adjuvant chemotherapy. One patient experienced recurrence 152 months after the operation, while the other 5 patients have survived disease-free. Four patients were treated with chemotherapy alone, two of whom experienced complete remission and the others partial remission. The final 2 patients received no treatment and had survived for 7 and 27 months respectively. All the patients were still alive at the most recent follow-up, 7 to 160 months (mean 71.3 months). CONCLUSIONS: Except radiography, no specific clinical manifestations could be identified for pulmonary MALToma. The final diagnosis should be based on histology and immunohistochemistry. Several treatment methods can be used to achieve good outcomes.

[Protective effects of ginaton against ischemia-reperfusion injury on the autograft after lung autotransplantation: experiment with rabbits].

OBJECTIVE: To investigate the effects of ginaton against ischemia-reperfusion injury on the autograft after lung autotransplantation. METHODS: Models of lung autotransplantation were established in 18 New Zealand rabbits were established. The 18 rabbits were randomly divided into 3 equal groups: group of simple ischemia-reperfusion (group I/R), undergoing ischemia by blocking the left pulmonary artery for 2 h and then re-perfusion for 90 min; group with perfusion of low potassium dextran solution (group LPD), undergoing perfusion of LSD solution before ischemia; and group with treatment of ginaton (group LPD + E), undergoing intravenous injection of ginaton 15 min before ischemia. Arterial blood samples were collected before ischemia, and 15, 60, and 90 min after re-perfusion to examine the alveolar oxygen pressure (PaO2). Serum tumor necrosis factor-alpha (TNF-alpha) was monitored before ischemia, and 30, 60, and 90 min after re-perfusion. Then the left lungs were taken out to undergo detection of dry/wet ratio (D/W), pathological examination, and contents of myeloperoxidase (MPO) and the malondialdehyde (MDA) in the lung tissues. RESULTS: (1) The PaO2 decreased significantly after reperfusion in all groups. And the PaO2 values at different time points of Group LPD + E were all significantly higher than those of Group I/R (all P < 0.01), however, there were no significant differences between Group LPD and Group LPD + E. (2) The TNF-alpha level after reperfusion increased in Group I/R and Group LPD, while in Group LPD + E it increased only 60 min and 90 min after the reperfusion. The TNF-alpha levels after reperfusion at all time points of Group LPD + E were all significantly lower than those of the other 2 groups (all P < 0.05). (3) The MPO and MDA levels at all time points after re-perfusion of Group LPD + E were all significantly lower than those of the other 2 groups (all P < 0.01). (4) The value of D/W ratio of Group LPD + E was significantly higher than those of the other 2 groups (both P < 0.01). (5) Pathological examination showed that the lung tissue lesion of Group I/R was severe. Interstitial inflammatory cell infiltration, intra-alveolar inflammatory cell aggregation, exudation and even hemorrhage could be observed. The pathological lesion of Group LPD + E was mild, no significant inflammatory cell infiltration or exudation was observed. CONCLUSION: Ginaton provides a protective effect against ischemia-reperfusion injury on the autograft after lung autotransplantation. The mechanism may be related with antioxidation, inhibition of neutrophil aggregation, and TNF-releasing.

[Diagnosis and treatment of primary pulmonary mucosa-associated lymphoid tissue lymphoma].

OBJECTIVE: To study the diagnosis and treatment for primary pulmonary mucosa-associated lymphoid tissue lymphoma. METHODS: The clinical data of 12 patients with primary pulmonary mucosa-associated lymphoid tissue lymphoma from August 1992 to May 2005 were analyzed. RESULTS: All the patients survived during the follow-up periods of 6 to 164 months (mean 70.3 months). Gastric mucosa-associated lymphoid tissue lymphoma was found to coexist in 2 patients. No specific symptoms or signs, or specific results of bronchoscopy, ultrasonography or bone marrow examination were found in these patients, except that radiography showed nodules with blurred margins with characteristic air bronchogram. The final diagnosis was based on histology and immunohistochemistry. Surgical resection was performed for 6 patients, including 5 radical operations and 1 partial resection, among which 4 patients received adjuvant chemotherapy. Recurrence occurred in 1 patient 12.7 years after the operation, while the other 5 patients got disease free survival. Chemotherapy alone was administered for 4 patients, among whom 2 patients got complete remission and the others got partial remission. The other 2 patients received no treatment and had survived for 6 and 26 months respectively. CONCLUSIONS: Except for the radiographic findings, there were no specific clinical manifestations for primary pulmonary mucosa-associated lymphoid tissue lymphoma. The final diagnosis should be made by histology and immunohistochemistry. Surgery and chemotherapy can be adopted for the patients with good outcomes.