Mucosa-associated Lymphoid Tissue Lymphoma of the Trachea in a Patient with Breast Cancer

A case of endobronchial mucosa-associated lymphoid tissue (MALT) lymphoma successfully treated with radiotherapy and a review of the literature

A 60-year-old man was noted to have an elevated lesion in the right mainstem bronchus on chest computed tomography (CT) during his annual medical checkup 3 years previously. The lesion had gradually increased in size. FDG-PET showed no accumulation. Bronchoscopy revealed 5 nodular smooth surface protrusions on the ventral surface of the right mainstem bronchus, with the largest lesion that measured 5 mm in diameter. Biopsy showed diffuse infiltration of small lymphocytes, positive for CD20 and subsequently diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. The lesions disappeared on chest CT after radiotherapy, and no recurrence has been observed after 5 years. We reviewed 48 cases of endobronchial MALT lymphoma in the literature and provided a comprehensive review of the literature to date including our case.

[Circular resection of the thoracic trachea for MALT lymphoma in an 81-year-old patient]

A rare clinical observation of primary tracheal MALT lymphoma is reported and difficulties of differential diagnosis are discussed. Tracheal neoplasms are rare tumors and characterized by delayed diagnosis after clinical manifestation (tracheal stenosis and associated complications). These tumors often occur an advanced age patients that complicates examination and surgical treatment. High risk is determined by type of surgery, possible postoperative complications and senile age.

Spontaneous regression of primary endobronchial extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of pulmonary origin is a relatively rare disease. In particular, reports of MALT lymphoma occurring and localized in the trachea or bronchus have been limited. Pulmonary MALT lymphoma has been reported to demonstrate spontaneous regression, whereas there is only one reported case of spontaneous regression of primary endobronchial MALT lymphoma. We herein report the case of a 70-year-old man with primary endobronchial MALT lymphoma who showed spontaneous regression with an interest of endobronchial findings.

Endobronchial Mucosa-associated Lymphoid Tissue Lymphoma: A Report of Two Cases and a Review of the Literature

Primary endobronchial mucosa-associated lymphoid tissue lymphoma (EML) is rare. We reviewed 20 cases of EML, including ours and case reports. We found that the location of tumor in 70% of these cases was limited to the trachea and main bronchus, and the form of tumor in 61% of these cases was several nodular protrusions. If a patient exhibits these characteristics, adequate specimen collection on bronchoscopy is important. Because the prognosis for patients with EML is good, tumors on the trachea and main bronchus should be treated, while those on the peripheral airway can be watched carefully.

Mucosa-associated lymphoid tissue lymphoma of the trachea associated with idiopathic pulmonary fibrosis: A case report and literature review

RATIONALE

Mucosa-associated lymphoid tissue (MALT) lymphoma of the trachea is a rare disease that has been shown to be associated with chronic antigenic stimulation. There have been few reports of MALT lymphoma of the trachea in association with idiopathic pulmonary fibrosis (IPF).

PATIENT CONCERNS

A 73-year-old patient visited with a 2-year history of dyspnea on exertion and productive cough, which had worsened 1 month ago.

DIAGNOSES

MALT lymphoma of the trachea associated with IPF.

INTERVENTIONS

After taking into consideration the age, poor performance status, and comorbidities of the patient and the extent of disease, we utilized an observational approach as a treatment strategy.

OUTCOMES

The patient is well without any evidence of progression for 12 months since the initial diagnosis.

LESSONS

We present a case of MALT lymphoma of the trachea associated with IPF. A common predisposing factor may exist for tracheal MALT lymphoma and IPF. As there are no randomized clinical trials focusing on tracheal MALT lymphoma, individualized treatment decision is important, and in some cases, simply monitoring the patient might be the most appropriate approach.