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Huang L, Chen T, Liang G, Rueckert JC, He J, Zhou H, Xie X. A case report of minimally invasive surgical resection for pulmonary mucosa-associated lymphoid tissue. JTCVS Tech 2023; 22:281-284. [PMID: 38152236 PMCID: PMC10750462 DOI: 10.1016/j.xjtc.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/07/2023] [Accepted: 08/10/2023] [Indexed: 12/29/2023] Open
Affiliation(s)
- Luyu Huang
- Department of Surgery, Competence Center of Thoracic Surgery, Charité University Hospital Berlin, Berlin, Germany
| | - Tianqing Chen
- Department of Thoracic Surgery, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong Province, China
| | - Guozhong Liang
- Department of Thoracic Surgery, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong Province, China
| | - Jens C. Rueckert
- Department of Surgery, Competence Center of Thoracic Surgery, Charité University Hospital Berlin, Berlin, Germany
| | - Junxiu He
- St George's University School of Medicine, True Blue, Grenada
| | - Haiyu Zhou
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaoping Xie
- Department of Thoracic Surgery, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong Province, China
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Tanaka Y, Kido T, Sakamoto N, Hara A, Kato T, Miyashita R, Ozasa M, Tokito T, Okuno D, Takeda K, Yura H, Takemoto S, Takazono T, Ishimoto H, Obase Y, Ishimatsu Y, Miyazaki Y, Mukae H. Lung Involvement in Adult T-Cell Lymphoma Diagnosed Using Bronchoscopic Cryobiopsy: A Case Report and Review of the Literature. Medicina (Kaunas) 2023; 59:2015. [PMID: 38004063 PMCID: PMC10673562 DOI: 10.3390/medicina59112015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
The diagnosis of pulmonary lymphoma using small tissue samples is difficult and often requires surgical procedures; thus, a less invasive sampling method is desirable. Moreover, pulmonary involvement in adult T-cell lymphoma (ATL) is often difficult to diagnose, especially in cases without characteristic flower cells. Here, we present the case of a 78-year-old man, in whom pathological examination of the transbronchial lung biopsy (TBLB) specimen did not reveal malignant findings; therefore, transbronchial lung cryobiopsy (TBLC) in combination with endobronchial ultrasonography (EBUS) was used to diagnose ATL based on the pathological findings. A literature review identified 18 cases of pulmonary lymphomas diagnosed using TBLC. Among the 19 cases, including our own, 16 cases were of B-cell lymphoma (84.2%), and the present case is the first case of ATL diagnosed using TBLC. Eighty percent of the cases underwent a biopsy (more than two samples) of the middle or lower lobe and were diagnosed without major complications. EBUS was used with TBLC in three cases to identify the location of the pulmonary lesions. In the present case, EBUS was also useful for avoiding vascular biopsy. Although large-scale prospective studies are required to establish precise guidelines for diagnosing pulmonary lymphomas using TBLC, our case report and review contributes to a deeper understanding of the diagnosis of rare diseases.
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Affiliation(s)
- Yasuhiro Tanaka
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takeharu Kato
- Department of Hematology, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (T.K.)
| | - Ritsuko Miyashita
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan;
| | - Yasushi Miyazaki
- Department of Hematology, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (T.K.)
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
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Uppal M, Hassan A, Ahari J. Diffuse large B cell lymphoma presenting as multiple cavitary lung lesions. BMJ Case Rep 2023; 16:e254367. [PMID: 37640418 PMCID: PMC10462952 DOI: 10.1136/bcr-2022-254367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
A female patient in her 50s presented to the hospital with a 2 months history of shortness of breath and productive cough. She also had ongoing fatigue and unintentional weight loss. Investigations demonstrated a normal white cell count and elevated lactate dehydrogenase). A CT scan of the chest revealed multiple bilateral cavitary lung masses and pulmonary nodules. Bronchoscopy with transbronchial biopsy and fine needle aspiration of mediastinal lymph node was performed. The histopathology was consistent with the non-germinal centre B cell subtype of diffuse large B cell lymphoma (DLBCL). A regimen of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone was started, which improved her symptoms. Although a rare presentation, this case highlights the need to consider DLBCL among the differential diagnoses for cavitary lung lesions when the workup fails to elicit an alternate cause. Given its aggressive nature, prompt diagnosis and treatment are critical.
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Affiliation(s)
- Manisha Uppal
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Ahmad Hassan
- Pulmonary and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Jalil Ahari
- Pulmonary and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Yu X, Kang B, Nie P, Deng Y, Liu Z, Mao N, An Y, Xu J, Huang C, Huang Y, Zhang Y, Hou Y, Zhang L, Sun Z, Zhu B, Shi R, Zhang S, Sun C, Wang X. Development and validation of a CT-based radiomics model for differentiating pneumonia-like primary pulmonary lymphoma from infectious pneumonia: A multicenter study. Chin Med J (Engl) 2023; 136:1188-1197. [PMID: 37083119 PMCID: PMC10278712 DOI: 10.1097/cm9.0000000000002671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
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Affiliation(s)
- Xinxin Yu
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Bing Kang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Pei Nie
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Yan Deng
- Department of Radiology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Zixin Liu
- Department of Medicine, Graduate School, Kyung Hee University, Seoul 446701, Republic of Korea
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai, Shandong 164000, China
| | - Yahui An
- Department of Research Collaboration, R&D Center, Beijing Deepwise & League of PHD Technology Co., Ltd, Beijing 100080, China
| | - Jingxu Xu
- Department of Research Collaboration, R&D Center, Beijing Deepwise & League of PHD Technology Co., Ltd, Beijing 100080, China
| | - Chencui Huang
- Department of Research Collaboration, R&D Center, Beijing Deepwise & League of PHD Technology Co., Ltd, Beijing 100080, China
| | - Yong Huang
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
| | - Yonggao Zhang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Longjiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
| | - Zhanguo Sun
- Department of Radiology, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, China
| | - Baosen Zhu
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Rongchao Shi
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Shuai Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Cong Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China
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Gozzi L, Cozzi D, Cavigli E, Moroni C, Giannessi C, Zantonelli G, Smorchkova O, Ruzga R, Danti G, Bertelli E, Luzzi V, Pasini V, Miele V. Primary Lymphoproliferative Lung Diseases: Imaging and Multidisciplinary Approach. Diagnostics (Basel) 2023; 13:diagnostics13071360. [PMID: 37046580 PMCID: PMC10093093 DOI: 10.3390/diagnostics13071360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Lymphoproliferative lung diseases are a heterogeneous group of disorders characterized by primary or secondary involvement of the lung. Primary pulmonary lymphomas are the most common type, representing 0.5–1% of all primary malignancies of the lung. The radiological presentation is often heterogeneous and non-specific: consolidations, masses, and nodules are the most common findings, followed by ground-glass opacities and interstitial involvement, more common in secondary lung lymphomas. These findings usually show a prevalent perilymphatic spread along bronchovascular bundles, without a prevalence in the upper or lower lung lobes. An ancillary sign, such as a “halo sign”, “reverse halo sign”, air bronchogram, or CT angiogram sign, may be present and can help rule out a differential diagnosis. Since a wide spectrum of pulmonary parenchymal diseases may mimic lymphoma, a correct clinical evaluation and a multidisciplinary approach are mandatory. In this sense, despite High-Resolution Computer Tomography (HRCT) representing the gold standard, a tissue sample is needed for a certain and definitive diagnosis. Cryobiopsy is a relatively new technique that permits the obtaining of a larger amount of tissue without significant artifacts, and is less invasive and more precise than surgical biopsy.
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Affiliation(s)
- Luca Gozzi
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Diletta Cozzi
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Edoardo Cavigli
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Chiara Moroni
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | | | - Giulia Zantonelli
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Olga Smorchkova
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Ron Ruzga
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Ginevra Danti
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Elena Bertelli
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Valentina Luzzi
- Interventional Pneumology, Careggi University Hospital, 50134 Florence, Italy
| | - Valeria Pasini
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, 50133 Florence, Italy
| | - Vittorio Miele
- Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
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Jung H, Kim HS, Han J, Ko YH, Choi YD, Lee T. Clinicopathological Characteristics of Primary Pulmonary Hodgkin Lymphoma (PPHL): Two Institutional Experiences with Comprehensive Literature Review of 115 PPHL Cases. J Clin Med 2022; 12:jcm12010126. [PMID: 36614926 PMCID: PMC9821715 DOI: 10.3390/jcm12010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Primary pulmonary Hodgkin lymphoma (PPHL) is an extremely rare condition. Its clinicopathological characteristics remain unclear because of the limited number of patients with PPHL. The aim of this study was to comprehensively analyze the clinicopathological characteristics of PPHL. We reviewed the electronic medical records and pathology slides of our 10 PPHL patients. The female-to-male ratio was 6:4, and the mean age was 41 years. Although three patients had no symptoms, seven had localized or generalized symptoms, including cough, sputum, chest discomfort/pain, and weight loss. Some cases had not been diagnosed as PPHL in the initial needle biopsy. Four patients underwent surgical resection. With chemotherapy, eight patients achieved complete remission. We also conducted a thorough literature review on 105 previously reported PPHL cases. Among a total of 115 PPHL cases, the most common subtype was nodular sclerosis (37.4%). More than half of the cases (55%) were clinically suspected as infectious pneumonia. Of 61 patients whose biopsies were available, 27 (44.3%) were diagnosed correctly as Hodgkin lymphoma, whereas the misdiagnoses included tuberculosis, Langerhans cell histiocytosis, solitary fibrous tumor, and adenocarcinoma. We demonstrated that PPHL represents a diagnostic challenge on small biopsies. Recognizing that this rare tumor can mimic infectious and inflammatory diseases as well as malignancies is important because the accurate diagnosis of PPHL is essential for adequate clinical management.
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Affiliation(s)
- Hera Jung
- Department of Pathology, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang 10414, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Joungho Han
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Young Hyeh Ko
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 10408, Republic of Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Taebum Lee
- Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Correspondence:
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Schapiro AH, Wikenheiser-Brokamp KA, Wermers JD, Rattan MS, Crotty EJ. Pulmonary lymphoproliferative disorders in children: a practical review. Pediatr Radiol 2022; 52:1224-33. [PMID: 35352133 DOI: 10.1007/s00247-022-05335-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/19/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
Pulmonary lymphoproliferative disorders represent an uncommon spectrum of proliferation of lymphoid tissue in the lung parenchyma ranging from benign hyperplasia to malignancy. They tend to occur in certain clinical situations and have typical imaging features that together can be used by the radiologist to suggest these entities as part of the differential diagnosis. We review key clinical, histopathological and computed tomography features of pulmonary lymphoproliferative disorders in children including follicular bronchiolitis, lymphoid interstitial pneumonia, granulomatous-lymphocytic interstitial lung disease, lymphoma and post-transplant lymphoproliferative disorder to familiarize the pediatric radiologist with this group of disorders.
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López Bauzá Á, López Ramírez C, Rodríguez Portal JA. Radiological Manifestations of a Rare and Unrecognized Disease: Primary Pulmonary Lymphoma. Arch Bronconeumol 2022; 58:429-430. [PMID: 35562232 DOI: 10.1016/j.arbres.2022.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Ángela López Bauzá
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), España.
| | - Cecilia López Ramírez
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - José Antonio Rodríguez Portal
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
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Bauzá ÁL, Ramírez CL, Portal JAR. [Translated article] Radiological Manifestations of a Rare and Sometimes Neglected Disease: Primary Pulmonary Lymphoma. Arch Bronconeumol 2022. [DOI: 10.1016/j.arbres.2022.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Wu T, Huang Y, Wang Z, Cao H, Ding Q, Deng Z. Pulmonary MALT lymphoma: imaging findings in 18 cases and the associated pathological correlations. Am J Med Sci 2022; 364:192-197. [DOI: 10.1016/j.amjms.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/01/2022]
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Ishikawa K, Nagashima T, Machida Y, Yasuda A, Yoshida K, Fujita M, Ochiai K, Azakami D, Michishita M. Primary pulmonary diffuse large B-cell lymphoma associated with feline leukaemia virus infection in a young cat. JFMS Open Rep 2022; 8:20551169221074240. [PMID: 35173973 PMCID: PMC8841923 DOI: 10.1177/20551169221074240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 4-year-old castrated male domestic shorthair cat with a continuous cough was brought to a private veterinary clinic for detailed examination. Radiography of the thoracic cavity revealed a severe radiopaque region in the caudal lobe of the right lung. At 108 days after the initial visit, CT showed a mass of 27 × 23 × 18 mm in the caudal lobe of the right lung. At that time, no abnormalities in other organs except for the lung were detected on CT and peripheral blood and blood biochemistry tests. The mass in the caudal lobe of the right lung was resected by lobectomy; it had a white surface and was firm. Histopathologically, the mass was non-encapsulated, showing an unclear boundary with surrounding tissues. The mass comprised large, round or polygonal neoplastic cells arranged in a diffuse pattern. Immunohistochemically, neoplastic cells were diffusely positive for CD20, feline leukaemia virus (FeLV) p27 and FeLV glycoprotein 70 but negative for CD3, CD204 and E-cadherin. Based on these findings, diffuse large B-cell lymphoma associated with FeLV infection was diagnosed. Although the cat showed no clinical signs of gastrointestinal or respiratory injury, a routine ultrasonography revealed thickening in the jejunum wall 196 days after lobectomy, and subsequent fine-needle aspiration examination confirmed high-grade lymphoma. Relevance and novel information This is the first report of primary pulmonary diffuse large B-cell lymphoma associated with FeLV infection in a young cat.
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Affiliation(s)
- Kento Ishikawa
- Department of Veterinary Pathology, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Tomokazu Nagashima
- Department of Veterinary Pathology, Nippon Veterinary and Life Science University, Tokyo, Japan
- Veterinary Medical Center, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yukino Machida
- Department of Veterinary Pathology, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Akiko Yasuda
- Veterinary Medical Center, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Karin Yoshida
- Veterinary Medical Center, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Michio Fujita
- Division of Veterinary Radiology, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Kazuhiko Ochiai
- Department of Veterinary Hygiene, Nippon Veterinary and Life Science University, Tokyo, Japan
- Research Center for Animal Life Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Daigo Azakami
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Masaki Michishita
- Department of Veterinary Pathology, Nippon Veterinary and Life Science University, Tokyo, Japan
- Research Center for Animal Life Science, Nippon Veterinary and Life Science University, Tokyo, Japan
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12
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Kido T, Ishimoto H, Ishii H, Hara K, Ozasa M, Kawabata H, Kawanami T, Suzuki Y, Yoshikawa H, Hara A, Sakamoto N, Matsumoto N, Yoshii C, Fukuoka J, Fujita M, Nakazato M, Kadota J, Mukae H, Yatera K. Combined detection of lymphocyte clonality and MALT1 translocations in bronchoalveolar lavage fluid for diagnosing pulmonary lymphomas. Sci Rep 2021; 11:23430. [PMID: 34873224 PMCID: PMC8648835 DOI: 10.1038/s41598-021-02861-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022] Open
Abstract
Diagnosis of pulmonary lymphoma using small tissue samples is difficult and often requires surgical procedures; thus, a less invasive sampling method is desirable. We previously showed that pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma can be diagnosed by detecting MALT lymphoma translocation gene 1 (MALT1) translocations in bronchoalveolar lavage fluid (BALF) cells. Analysis of B-cell clonality based on immunoglobulin heavy chain (IGH) gene rearrangements was also reportedly useful for diagnosing pulmonary lymphoma. The aim of this prospective multicenter study was to evaluate the yet unknown diagnostic potential of combined detection of MALT1 translocations and clonality using BALF. We analyzed B- and T-cell clonality based on IGH and T-cell receptor (TCR) rearrangements together with MALT1 translocations using BALF of patients with clinically suspected pulmonary lymphomas. In total, 39 patients were evaluated and categorized into three groups: B-cell lymphoma, lymphoproliferative disorders, and other diseases. IGH rearrangement detection for B-cell lymphoma diagnosis exhibited sensitivity and specificity of 88.9% and 90.0%, respectively. TCR rearrangements were not observed in patients with B-cell lymphomas. The presence of IGH rearrangements together with the absence of TCR rearrangements indicated 96.0% specificity for the diagnosis of B-cell lymphoma. The sensitivity and specificity of MALT1 translocations for diagnosing MALT lymphoma were 28.6% and 100%, respectively. The combined detection of lymphocyte clonality and MALT1 translocations using BALF is suitable for screening and diagnosis of B-cell lymphomas. Analysis of specific genes such as MALT1 should improve the precision of B-cell lymphoma diagnosis.
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Affiliation(s)
- Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. .,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Kanako Hara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroki Kawabata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yu Suzuki
- Department of Respiratory Medicine, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Hiroki Yoshikawa
- Department of Respiratory Medicine and Infectious Disease, Faculty of Medicine, Oita University, Yufu, Japan
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Nobuhiro Matsumoto
- Neurology, Respirology, Endocrinology and Metabolism, Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Chiharu Yoshii
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Masamitsu Nakazato
- Neurology, Respirology, Endocrinology and Metabolism, Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Junichi Kadota
- Department of Respiratory Medicine and Infectious Disease, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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13
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Smyth R, Sloan JM, Burks E, Hawkins F. Primary pulmonary marginal zone lymphoma: an unusual cause of pulmonary infiltrates. Respirol Case Rep 2021; 9:e00806. [PMID: 34221408 PMCID: PMC8239556 DOI: 10.1002/rcr2.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/01/2021] [Accepted: 06/11/2021] [Indexed: 11/07/2022] Open
Abstract
Primary pulmonary extra-nodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), also known as bronchus-associated lymphoid tissue (BALT lymphoma), is the most common primary pulmonary lymphoma but is rare (<1%) among all non-Hodgkin lymphomas and among pulmonary neoplasms in general. We herein report the case of a 59-year-old male who presented with stable exertional dyspnoea and persistent lung infiltrates who was referred to our hospital for further assessment. A computed tomography (CT)-guided core biopsy was performed showing a dense lymphoid infiltrate, with further testing revealing the diagnosis of pulmonary MALT lymphoma. This uncommon lung tumour is usually seen in older adults and typically associated with a relatively indolent course. Rituximab, an anti-CD20 antibody, has been shown to be effective in up to 70% of cases.
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Affiliation(s)
- Robert Smyth
- Department of Pulmonary and Critical Care MedicineBoston University School of Medicine, Boston Medical CenterBostonMAUSA
| | - John Mark Sloan
- Department of Hematology and OncologyBoston University School of Medicine, Boston Medical CenterBostonMAUSA
| | - Eric Burks
- Department of Pathology and Laboratory MedicineBoston University School of Medicine, Boston Medical CenterBostonMAUSA
| | - Finn Hawkins
- Department of Pulmonary and Critical Care MedicineBoston University School of Medicine, Boston Medical CenterBostonMAUSA
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14
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Lat T, Sanchez JF, McGraw MK, Hodjat P, White HD, Boethel CD. Decision-making in diagnosis of bronchus-associated lymphoid tissue lymphoma. Proc (Bayl Univ Med Cent) 2021; 34:451-455. [PMID: 34219924 DOI: 10.1080/08998280.2021.1889275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Bronchus-associated lymphoid tissue (BALT) lymphomas of the lung are uncommon, and diagnosis is often delayed due to the indolent clinical course. Often, adequate samples are difficult to obtain by bronchoscopy with transbronchial biopsy alone. This retrospective study reviewed the diagnosis and treatment of BALT lymphoma cases at our institution over the course of 19 years. Most patients were white, women, and >50 years old; the mean Charlson Comorbidity Index at the time of diagnosis was 6. Seven of 12 patients presented with solitary nodules or multiple nodules. For six cases, initial modalities were nondiagnostic; four subsequently underwent surgical biopsy, one underwent computed tomography-guided biopsy, and one underwent navigational bronchoscopy for final diagnosis of BALT lymphoma. Ultimately, 55% of cases were diagnosed with nonsurgical biopsy. One patient suffered a pneumothorax related to the initial diagnostic attempt. Ten patients received chemotherapy, radiation, and/or surgery, and 11 of the 12 are still alive. Our data confirm the previously described indolent behavior of BALT lymphomas and the challenges related to diagnosis. While previous studies have suggested surgical biopsy as the primary modality for obtaining histopathology, navigational bronchoscopy could serve as a safer alternative.
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Affiliation(s)
- Tasnim Lat
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Juan F Sanchez
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Meghan K McGraw
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Parsa Hodjat
- Department of Pathology, Baylor Scott & White Health, Temple, Texas
| | - Heath D White
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
| | - Carl D Boethel
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas
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15
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Sanguedolce F, Zanelli M, Zizzo M, Bisagni A, Soriano A, Cocco G, Palicelli A, Santandrea G, Caprera C, Corsi M, Cerrone G, Sciaccotta R, Martino G, Ricci L, Sollitto F, Loizzi D, Ascani S. Primary Pulmonary B-Cell Lymphoma: A Review and Update. Cancers (Basel) 2021; 13:cancers13030415. [PMID: 33499258 PMCID: PMC7865219 DOI: 10.3390/cancers13030415] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/10/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary 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. Abstract 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.
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Affiliation(s)
- Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, 71122 Foggia, Italy
- Correspondence: ; Tel.: +39-0881-736315
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Alessandra Bisagni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Alessandra Soriano
- Gastroenterology, Division and Inflammatory Bowel Disease Center, Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Giorgia Cocco
- Radiotherapy Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, 71122 Foggia, Italy;
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Giacomo Santandrea
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Cecilia Caprera
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Matteo Corsi
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Giulia Cerrone
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Raffaele Sciaccotta
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Linda Ricci
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Francesco Sollitto
- Institute of Thoracic Surgery, University of Foggia, 71122 Foggia, Italy; (F.S.); (D.L.)
| | - Domenico Loizzi
- Institute of Thoracic Surgery, University of Foggia, 71122 Foggia, Italy; (F.S.); (D.L.)
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
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16
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Kim D, Elgeti T, Penzkofer T, Steffen IG, Jensen LJ, Schwartz S, Hamm B, Nagel SN. Enhancing the differentiation of pulmonary lymphoma and fungal pneumonia in hematological patients using texture analysis in 3-T MRI. Eur Radiol 2021; 31:695-705. [PMID: 32822054 DOI: 10.1007/s00330-020-07137-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/08/2020] [Accepted: 08/03/2020] [Indexed: 11/15/2022]
Abstract
Objectives To evaluate texture analysis in nonenhanced 3-T MRI for differentiating pulmonary fungal infiltrates and lymphoma manifestations in hematological patients and to compare the diagnostic performance with that of signal intensity quotients (“nonenhanced imaging characterization quotients,” NICQs). Methods MR scans were performed using a speed-optimized imaging protocol without an intravenous contrast medium including axial T2-weighted (T2w) single-shot fast spin-echo and T1-weighted (T1w) gradient-echo sequences. ROIs were drawn within the lesions to extract first-order statistics from original images using HeterogeneityCAD and PyRadiomics. NICQs were calculated using signal intensities of the lesions, muscle, and fat. The standard of reference was histology or clinical diagnosis in follow-up. Statistical testing included ROC analysis, clustered ROC analysis, and DeLong test. Intra- and interrater reliability was tested using intraclass correlation coefficients (ICC). Results Thirty-three fungal infiltrates in 16 patients and 38 pulmonary lymphoma manifestations in 19 patients were included. Considering the leading lesion in each patient, diagnostic performance was excellent for T1w entropy (AUC 80.2%; p < 0.005) and slightly inferior for T2w energy (79.9%; p < 0.005), T1w uniformity (79.6%; p < 0.005), and T1w energy (77.0%; p < 0.01); the best AUC for NICQs was 72.0% for T2NICQmean (p < 0.05). Intra- and interrater reliability was good to excellent (ICC > 0.81) for these parameters except for moderate intrarater reliability of T1w energy (ICC = 0.64). Conclusions T1w entropy, uniformity, and energy and T2w energy showed the best performances for differentiating pulmonary lymphoma and fungal pneumonia and outperformed NICQs. Results of the texture analysis should be checked for their intrinsic consistency to identify possible incongruities of single parameters. Key Points • Texture analysis in nonenhanced pulmonary MRI improves the differentiation of pulmonary lymphoma and fungal pneumonia compared with signal intensity quotients. • T1w entropy, uniformity, and energy along with T2w energy show the best performances for differentiating pulmonary lymphoma from fungal pneumonia. • The results of the texture analysis should be checked for their intrinsic consistency to identify possible incongruities of single parameters.
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17
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Fu M, Mani M, Bradford J, Chen W, Chen M, Fuda F. Application of flow cytometry in the analysis of lymphoid disease in the lung and pleural space. Semin Diagn Pathol 2020; 37:303-320. [PMID: 32768250 DOI: 10.1053/j.semdp.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 11/11/2022]
Abstract
Various types of lymphoid neoplasms can occur in the lung. Lung parenchyma, the pleura or the pleural cavity can be the primary site of a lymphoid neoplasm or can be involved secondarily as a result of systemic dissemination from a separate primary site. Recognition of pulmonary lymphoid neoplasms (PLN) has increased secondary to technological advances in the medical field. Multiparameter flow cytometry (FC) is a one of the diagnostic tools that serves an essential role in the detecting and categorizing PLNs. FC allows for rapid identification and immunophenotypic characterization of PLN. In this article, we discuss the role of FC in the diagnosis of the most commonly encountered PLNs as well as their basic clinicopathologic features. We briefly discuss the role of FC in identifying non-hematolymphoid neoplasms in lung specimens as well.
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Affiliation(s)
- May Fu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Malary Mani
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jaclyn Bradford
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Weina Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mingyi Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Franklin Fuda
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX.
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18
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Frazier AA, Hossain R. A Spectrum of Metastatic Disease in the Chest: Insights for the Radiologist. Semin Roentgenol 2019; 55:51-59. [PMID: 31964481 DOI: 10.1053/j.ro.2019.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aletta Ann Frazier
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD; American Institute for Radiologic Pathology, American College of Radiology, Silver Spring, MD.
| | - Rydhwana Hossain
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
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19
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Cozzi D, Dini C, Mungai F, Puccini B, Rigacci L, Miele V. Primary pulmonary lymphoma: imaging findings in 30 cases. Radiol Med 2019; 124:1262-1269. [PMID: 31583557 DOI: 10.1007/s11547-019-01091-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/25/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To present our experience of cases of primary pulmonary lymphoma (PPL) found between January 2002 and July 2018, focusing on the radiological features and the differential diagnosis in order to contribute to the difficult role of the radiologist in the disease identification and to help the clinicians to reach the diagnosis. MATERIALS AND METHODS CT scans of 30 patients (14 men and 16 women, aged 58-86, mean age 72 years) with PPL were retrospectively reviewed. All patients had a histopathological confirmation of the disease: MALT lymphoma (23 patients, 76.6%); diffuse large B-cell lymphoma-DLBCL (seven patients, 23.4%). All the staging CT scans were evaluated by three experienced radiologists dedicated to thoracic disease in order to radiologically define the predominant pattern of presentation. RESULTS The following parenchymal patterns were observed: 11 patients with single/multiple nodules, five with masses/mass-like consolidations, 14 with consolidations with air bronchogram, 16 with ground-glass opacity, ten with angiogram sign, 22 with perilymphatic and/or peribronchovascular spread, 15 with associated lymphadenopathies, and 13 with pleural/chest wall involvement. The main characteristics of PPLs were the presence of consolidations and ground-glass opacities, with perilymphatic and/or bronchovascular spread. CONCLUSION All the characteristics of the work should alert the radiologist to consider lymphoma among the possible differential diagnoses, always correlating the results of the CT examination with appropriate clinical laboratory evaluations.
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Affiliation(s)
- Diletta Cozzi
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Catia Dini
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Francesco Mungai
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Benedetta Puccini
- Haematology Unit - Department of Oncology, University Hospital Careggi, Florence, Italy
| | - Luigi Rigacci
- Haematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy.
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20
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Low SK, Zayan AH, Istanbuly O, Nguyen Tran MD, Ebied A, Mohamed Tawfik G, Huy NT. Prognostic factors and nomogram for survival prediction in patients with primary pulmonary lymphoma: a SEER population-based study. Leuk Lymphoma 2019; 60:3406-3416. [PMID: 31322026 DOI: 10.1080/10428194.2019.1633636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Primary pulmonary lymphomas (PPLs) are rare lymphoproliferative malignancies arising from the lungs. The prognostic factors and optimal management of PPL have not been clearly defined due to its rarity. This study sought to characterize the significant prognostic factors and develop a validated nomogram for individualized prediction of survival outcomes in patients with PPL. A total of 2325 patients diagnosed with PPL between 1983 and 2010 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Older age at diagnosis, males, Hispanic race, non-marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue histology, Ann Arbor stage IV were significantly associated with worse OS on multivariable analysis. All treatment modalities, including chemotherapy, surgery, and radiotherapy were independent predictors of survival on univariable analysis. The nomogram built demonstrated good discriminative ability and calibration, with the C-index of 0.690 and 0.730 in the training and validation cohorts, respectively.
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Affiliation(s)
- Soon Khai Low
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | | | - Obaida Istanbuly
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Minh Duc Nguyen Tran
- Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Amr Ebied
- Egyptian National Blood Transfusion Services, Cairo, Egypt
| | | | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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21
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Abstract
Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is the most common primary pulmonary lymphoma. There are limited studies on imaging features of pulmonary MALT lymphoma. We present the computed tomography (CT) manifestations of pulmonary MALT lymphoma and the correlation between CT manifestations and clinical characteristics. Patients (n = 53) with histologically confirmed pulmonary MALT lymphoma who underwent chest CT scanning were retrospectively analyzed. Evaluated findings included distribution of pulmonary lesions, morphological pattern of appearance, contrast enhancement features, size, presence of thoracic lymphadenopathy, and secondary associated features. Pulmonary MALT lymphoma was observed in multiple (79%) and bilateral (66%) disease with random distribution (≥70%) of pulmonary lesions. The most frequent morphological pattern was consolidation (n = 33, 62%), followed by nodule (n = 23, 43%) and mass (n = 11, 21%). Common associated features were air bronchograms and bronchiectasis, especially cystic bronchiectasis and angiogram sign. Asymptomatic patients had less consolidation and bronchiectasis than did symptomatic patients. Cystic bronchiectasis was only observed in the symptomatic group. In conclusion, pulmonary MALT lymphoma manifests as diverse patterns on CT scans. Consolidation combined with cystic bronchiectasis was a characteristic late sign, which may assist in differential diagnosis. High-resolution CT images and multiplanar reconstruction techniques are helpful for accurately determining imaging manifestations.
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22
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Ullah S, Ali M, Song M. Rare Primary Pulmonary Marginal Zone Lymphoma Presenting with Incidental Pulmonary Nodules. Case Rep Pulmonol 2019; 2019:7031868. [PMID: 31016061 DOI: 10.1155/2019/7031868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/04/2019] [Indexed: 11/17/2022] Open
Abstract
Pulmonary malignancies carry a significant morbidity and mortality and are one of the leading causes of cancer-related deaths worldwide. Primary pulmonary lymphoma is a rare malignancy which should be considered in the differential of solitary pulmonary nodule or lung mass especially in a low-risk patient presenting with constitutional symptoms. Here, we describe a case of an elderly male who presented to our clinic with incidental pulmonary nodules and subsequent workup revealed low grade B cell non-Hodgkin's lymphoma consistent with diagnosis of primary pulmonary marginal zone lymphoma.
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23
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Panagiotidou E, Kotoulas SC, Kilmpasani M, Pastelli N, Akritidou S, Chatzopoulos E, Bikos V, Bagalas V, Fekete-Passa K, Stanopoulos I, Pataka A. Α 78-year-old female who presents with a non-resolving pneumonia: what is your diagnosis? Breathe (Sheff) 2019; 14:e123-e127. [PMID: 30820252 PMCID: PMC6388653 DOI: 10.1183/20734735.034218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Non-resolving pneumonia with a mass-like radiological appearance raises clinical suspicion of many causes, with malignancy the most prominent. Infectious causes should be investigated thoroughly as they carry a better prognosis. http://ow.ly/QEPL30mLIk4.
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Affiliation(s)
- Evangelia Panagiotidou
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | | | - Maria Kilmpasani
- Laboratory of Pathology, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Nikoleta Pastelli
- Laboratory of Pathology, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Sofia Akritidou
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Evangelos Chatzopoulos
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Vasilis Bikos
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Vasilios Bagalas
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Katalin Fekete-Passa
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
| | - Ioannis Stanopoulos
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece.,Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Pataka
- Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece.,Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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24
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Abstract
Pulmonary nodular lymphoid hyperplasia is an uncommon reactive lymphoproliferative disorder that presents as an asymptomatic lung mass. The histopathologic diagnosis of pulmonary nodular lymphoid hyperplasia may be challenging because of its morphologic overlap with other diseases, such as extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and immunoglobulin G4-related sclerosing disease. Despite the similarities, there are distinctive morphologic and phenotypic features that allow for the correct diagnosis in the majority of cases. This review aims to discuss the clinicopathologic features of pulmonary nodular lymphoid hyperplasia and contrast them with its histopathologic mimickers.
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Affiliation(s)
- Maggie Yell
- From the Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown (Dr Yell); and the Department of Pathology, University of Texas Southwestern Biocenter, Dallas (Dr Rosado)
| | - Flavia G Rosado
- From the Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown (Dr Yell); and the Department of Pathology, University of Texas Southwestern Biocenter, Dallas (Dr Rosado)
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25
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Leite-Filho RV, Panziera W, Bandinelli MB, Pavarini SP. Pathological Characterization of Lymphoma with Pulmonary Involvement in Cats. J Comp Pathol 2018; 165:6-12. [PMID: 30502798 DOI: 10.1016/j.jcpa.2018.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/21/2018] [Accepted: 09/12/2018] [Indexed: 01/15/2023]
Abstract
Studies evaluating histological patterns of lung infiltration by lymphoma in cats are lacking. We evaluated retrospectively the histological patterns of 125 necropsy cases of feline lymphoma collected over a 12-year period. Of the 125 cases, 16 showed lung infiltration (12.8%). Nine cats were female, seven cats were male and all were of mixed breed. Gross lesions observed in the lungs consisted of masses (25%) and nodules (18.7%); however, the majority of cases (56.2%) did not show any gross abnormality. Peribronchial-vascular infiltration (93.7%) was the most frequent pattern, followed by pleural (56.2%), interstitial (50%), nodular (37.5%) and alveolar (12.5%) patterns, but 75% of the cases had more than one pulmonary infiltration pattern. There were 14 (87.5%) B-cell and two (12.5%) T-cell lymphomas. Six cats (37.5%) were positive for feline leukaemia virus and three cats (18.7%) were positive for feline immunodeficiency virus. Diffuse large B-cell lymphoma was the most frequent type, accounting for 56% of all cases.
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Affiliation(s)
- R V Leite-Filho
- Setor de Patologia Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - W Panziera
- Setor de Patologia Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - M B Bandinelli
- Setor de Patologia Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - S P Pavarini
- Setor de Patologia Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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26
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Sachdev R, Goel S, Rastogi N, Yadav SP, Mohapatra I. Unusual presentation of syncytial variant of nodular sclerosis classical Hodgkin's lymphoma presenting as unilateral lung mass in a 15-year-old child. Acta Oncol 2018; 57:1729-1732. [PMID: 30102114 DOI: 10.1080/0284186x.2018.1502465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ritesh Sachdev
- Department of Pathology, Lab Medicine and Transfusion Medicine, Medanta – The Medicity Hospital, Gurgaon, India
| | - Shalini Goel
- Department of Pathology, Lab Medicine and Transfusion Medicine, Medanta – The Medicity Hospital, Gurgaon, India
| | - Neha Rastogi
- Department of Paediatric Oncology and Bone Marrow Transplantation, Medanta – The Medicity Hospital, Gurgaon, India
| | - Satya Prakash Yadav
- Department of Paediatric Oncology and Bone Marrow Transplantation, Medanta – The Medicity Hospital, Gurgaon, India
| | - Ishani Mohapatra
- Department of Pathology, Lab Medicine and Transfusion Medicine, Medanta – The Medicity Hospital, Gurgaon, India
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27
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Conti L, Pisani D, Gatt A, Montefort S. Unusual case of primary pulmonary Hodgkin's lymphoma presenting with a continuous murmur. BMJ Case Rep 2018; 2018:bcr-2018-225674. [PMID: 30269089 DOI: 10.1136/bcr-2018-225674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Systemic to pulmonary fistulas are an unusual entity, even more so in association with Hodgkin's lymphoma. We herein report a case of a 33-year-old woman that presented with an incidental lung lesion on a chest radiograph with an associated high-frequency continuous murmur over the lesion. The diagnosis of primary pulmonary Hodgkin's lymphoma, nodular sclerosis type, was obtained by a CT transthoracic biopsy. We achieved an excellent response after polychemotherapy with near-complete disappearance of the mass and a residual faint systolic murmur over the lesion.
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Affiliation(s)
- Luca Conti
- Department of Medicine, Mater Dei Hospital, Msida, Malta
| | - David Pisani
- Histopathology Department, Mater Dei Hospital, Msida, Malta
| | - Alexander Gatt
- Department of Haematology, Mater Dei Hospital, Msida, Malta
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28
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Abstract
Pulmonary lymphoproliferative neoplasms are rare lung tumors and account for <1% of all lung tumors. Among them, primary pulmonary lymphomas (PPL) constitute the majority, which include Non-Hodgkin's lymphoma (NHL) that comprise of mucosa-associated lymphoid tissue lymphoma, diffuse large B-cell lymphomas and other rare types of NHL and lymphomatoid granulomatosis. HL, which arises secondary to contiguous spread from the mediastinum, is the rarest type of PPL. Other entities described within the umbrella of pulmonary lymphoproliferative neoplasms include pleural lymphomas and posttransplant lymphoproliferative disorders (PTLD) - which occurs in the poststem cell and organ transplant patients. These neoplasms although rare, have a favorable prognosis, which does not depend on disease resectability. Moreover, with its nonspecific presentation, diagnosis is challenging, which often leads to delayed diagnosis or misdiagnosis in many cases. Therefore, knowledge of this entity is important for the practicing pulmonologist. This review article aims to describe the clinical presentation, diagnosis and management of primarily the entities within PPL, as well as pleural lymphomas and PTLD.
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Affiliation(s)
- Victoria K Tang
- Department of Internal Medicine, Divisions of Critical Care, Pulmonary and Sleep Medicine, UT Health- McGovern Medical School, Houston, Texas, USA
| | - Praveen Vijhani
- Department of Internal Medicine, Divisions of Critical Care, Pulmonary and Sleep Medicine, UT Health- McGovern Medical School, Houston, Texas, USA
| | - Sujith V Cherian
- Department of Internal Medicine, Divisions of Critical Care, Pulmonary and Sleep Medicine, UT Health- McGovern Medical School, Houston, Texas, USA
| | - Manju Ambelil
- Department of Pathology and Laboratory Medicine, UT Health- McGovern Medical School, Houston, Texas, USA
| | - Rosa M Estrada–Y-Martin
- Department of Internal Medicine, Divisions of Critical Care, Pulmonary and Sleep Medicine, UT Health- McGovern Medical School, Houston, Texas, USA
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Rajagopal MD, Gochhait D, Hanuman Srinivas B, Ganesh RN, Siddaraju N, Rajaram M. Bronchial brush cytology of primary anaplastic large cell lymphoma of lung. Diagn Cytopathol 2018; 46:760-763. [DOI: 10.1002/dc.23944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 01/14/2018] [Accepted: 03/28/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Meyyappa Devan Rajagopal
- Department of Pathology; Jawaharlal Institute of Post Graduate Medical Education and Research; Dhanwantri Nagar Puducherry 605006 India
| | - Debasis Gochhait
- Department of Pathology; Jawaharlal Institute of Post Graduate Medical Education and Research; Dhanwantri Nagar Puducherry 605006 India
| | - Bheemanathi Hanuman Srinivas
- Department of Pathology; Jawaharlal Institute of Post Graduate Medical Education and Research; Dhanwantri Nagar Puducherry 605006 India
| | - Rajesh Nachiappa Ganesh
- Department of Pathology; Jawaharlal Institute of Post Graduate Medical Education and Research; Dhanwantri Nagar Puducherry 605006 India
| | - Neelaiah Siddaraju
- Department of Pathology; Jawaharlal Institute of Post Graduate Medical Education and Research; Dhanwantri Nagar Puducherry 605006 India
| | - Manju Rajaram
- Department of Pulmonary Medicine; Jawaharlal Institute of Post Graduate Medical Education and Research; Dhanwantri Nagar Puducherry 605006 India
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30
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Aguiar-Bujanda D, Ros-Sanjuan L, Hernandez-Sosa M, Perera-Romero C. An unexpected diagnosis in a patient with new-onset pulmonary infiltrates during adjuvant therapy for breast cancer. Oxf Med Case Reports 2018; 2018:omx095. [PMID: 29479451 PMCID: PMC5806405 DOI: 10.1093/omcr/omx095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/17/2017] [Indexed: 11/22/2022] Open
Abstract
The differential diagnosis of new-onset pulmonary infiltrates during adjuvant therapy in a cancer patient is challenging. Opportunistic infections, pulmonary drug-induced toxicity and metastatic dissemination of the underlying cancer are the most common causes. However, although infrequent, the development of a second primary pulmonary neoplasia should be taken into account. We present the clinical case of a breast cancer patient who developed progressive pulmonary infiltrates during adjuvant therapy, who was finally diagnosed as having a second lung neoplasm of unexpected histology.
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Affiliation(s)
- David Aguiar-Bujanda
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
- Correspondence address. Department of Medical Oncology. Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria. Spain. Tel: +34-928-450400; Fax: +34-928-450079; E-mail:
| | - Laura Ros-Sanjuan
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
| | - Maria Hernandez-Sosa
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
| | - Carmen Perera-Romero
- Department of Nuclear Medicine, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
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Abstract
Non-Hodgkin lymphoma (NHL) frequently manifests in extranodal structures in the chest, often in the form of secondary involvement but occasionally as primary disease. Because staging and treatment are affected by the presence of extranodal disease at imaging, radiologists' interpretation and management of suspicious findings are critical to patient care. Unfortunately, owing to considerable imaging overlap with other diseases, primary extranodal lymphoma is difficult to diagnose with imaging alone. Radiologists should have a heightened degree of suspicion in patients at risk (including patients with immune compromise, autoimmune diseases, or a history of stem cell or solid organ transplant) or with particular imaging appearances (including the vertebral wraparound sign, nonresolving consolidation, an infiltrative soft-tissue mass, and lesions demonstrating vascular encasement without invasion). For patients with known NHL, positron emission tomography/computed tomography (PET/CT) using fluorine 18 (18F)-labeled fluorodeoxyglucose (FDG) is now preferred for routine staging in most cases. CT remains heavily used, and identification of subtle extranodal involvement with CT can be improved with use of intravenous contrast material and careful review of multiplanar images. Pericardial effusion, pleural soft tissue (even when mild), mass-like consolidation, perilymphatic nodularity, and new lytic bone lesions are particularly suggestive of secondary involvement in a patient with known NHL. Magnetic resonance imaging is a helpful problem-solving tool when equivocal findings would change staging and treatment. This comprehensive review illustrates the spectrum of CT manifestations of extranodal NHL in the chest, including the pleura, lung, airways, heart, pericardium, esophagus, chest wall, and breast. ©RSNA, 2017.
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Affiliation(s)
- Mathew P Bligh
- From the Department of Diagnostic Radiology (M.P.B., J.N.B., S.C.B., D.M.) and Division of Hematology, Department of Medicine (D.A.M.), Dalhousie University, Room 307, Victoria Building, 1276 S Park St, Halifax, NS, Canada B3H 2Y9
| | - Joy N Borgaonkar
- From the Department of Diagnostic Radiology (M.P.B., J.N.B., S.C.B., D.M.) and Division of Hematology, Department of Medicine (D.A.M.), Dalhousie University, Room 307, Victoria Building, 1276 S Park St, Halifax, NS, Canada B3H 2Y9
| | - Steven C Burrell
- From the Department of Diagnostic Radiology (M.P.B., J.N.B., S.C.B., D.M.) and Division of Hematology, Department of Medicine (D.A.M.), Dalhousie University, Room 307, Victoria Building, 1276 S Park St, Halifax, NS, Canada B3H 2Y9
| | - David A MacDonald
- From the Department of Diagnostic Radiology (M.P.B., J.N.B., S.C.B., D.M.) and Division of Hematology, Department of Medicine (D.A.M.), Dalhousie University, Room 307, Victoria Building, 1276 S Park St, Halifax, NS, Canada B3H 2Y9
| | - Daria Manos
- From the Department of Diagnostic Radiology (M.P.B., J.N.B., S.C.B., D.M.) and Division of Hematology, Department of Medicine (D.A.M.), Dalhousie University, Room 307, Victoria Building, 1276 S Park St, Halifax, NS, Canada B3H 2Y9
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Su P, Wang F, Qi B, Wang T, Zhang S. P53 Regulation-Association Long Non-Coding RNA (LncRNA PRAL) Inhibits Cell Proliferation by Regulation of P53 in Human Lung Cancer. Med Sci Monit 2017; 23:1751-1758. [PMID: 28396580 PMCID: PMC5398470 DOI: 10.12659/msm.900205] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Lung cancer is among the most common causes of cancer-related deaths worldwide, but its tumorigenic mechanisms are largely unknown. Long non-coding RNAs (LncRNAs) have been shown to have significant roles in multiple cancers. Herein, we aimed to elucidate the detailed effects of a newly-discovered LncRNA, termed PRAL, on cell proliferation in lung cancer. MATERIAL AND METHODS A total of 100 lung cancer patients were subjected to RT-PCR analysis to detect the expressions of PRAL. Western blot analysis was performed to examine P53 protein levels. PRAL plasmid and specific siRNA against P53 was transfected into lung cancer cell lines NCI-H929 and A549. Cell viability assay was conducted in the presence or absence of siP53. RESULTS The transcript level of PRAL in human lung cancer was remarkably decreased in vivo compared with their adjacent non-cancerous counterparts, and the protein levels of P53 were accordingly suppressed. Moreover, the expression of PRAL was also decreased in all of the 5 lung cancer cell lines. Transfection of PRAL plasmid inhibited cell proliferation in NCI-H929 and A549 cells and promoted the transcription of P53; however, knockdown of P53 caused no notable effects on PRAL transcription, but it retarded the inhibitory effects mediated by PRAL. CONCLUSIONS The transcript level of PRAL was decreased in lung cancer in vivo and in vitro. Overexpression of PRAL inhibited cell proliferation by upregulating the expression of P53. Our results indicate that PRAL might be a tumor suppressor in lung cancer and thus provides novel clues for the diagnosis and treatment for lung cancer in clinical practice.
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Affiliation(s)
- Pengxiao Su
- Department of Surgery, Xi'an Red Cross Hospital, Affiliated to School of Medicine, Xi'an Jiao Tong University, Xi'an, Shanxi, China (mainland)
| | - Fengqin Wang
- Maternal and Child Care Service Center of Changan District, Xi'an, Shanxi, China (mainland)
| | - Bin Qi
- Department of Surgery, Xi'an Red Cross Hospital, Affiliated to School of Medicine, Xi'an Jiao Tong University, Xi'an, Shanxi, China (mainland)
| | - Ting Wang
- Department of Surgery, Xi'an Red Cross Hospital, Affiliated to School of Medicine, Xi'an Jiao Tong University, Xi'an, Shanxi, China (mainland)
| | - Shaobo Zhang
- Department of Surgery, Xi'an Red Cross Hospital, Affiliated to School of Medicine, Xi'an Jiao Tong University, Xi'an, Shanxi, China (mainland)
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Sirajuddin A, Raparia K, Lewis VA, Franks TJ, Dhand S, Galvin JR, White CS. Primary Pulmonary Lymphoid Lesions: Radiologic and Pathologic Findings. Radiographics 2016; 36:53-70. [PMID: 26761531 DOI: 10.1148/rg.2016140339] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The pulmonary lymphoid system is complex and is composed of two compartments: the pulmonary lymphatics and the bronchus-associated lymphoid tissue (BALT). Additional important cells that function in the pulmonary lymphoid system include dendritic cells, Langherhans cells, macrophages, and plasma cells. An appreciation of the normal lymphoid anatomy of the lung as well as its immunology is helpful in understanding the radiologic and pathologic findings of the primary pulmonary lymphoid lesions. Primary lymphoid lesions of the lung arise from the BALT and are uncommon. However, they are increasingly recognized within the growing number of posttransplant patients as well as other patients who are receiving immunosuppressive therapies. Primary lymphoid lesions encompass a wide range of benign and malignant lesions. Benign lymphoid lesions of the lung include reactive lymphoid hyperplasia, follicular bronchiolitis, lymphoid interstitial pneumonia, and nodular lymphoid hyperplasia. Malignant lymphoid lesions of the lung include low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), other non-Hodgkin lymphomas, and Hodgkin lymphoma. Last, a miscellaneous group of primary lymphoid lesions includes lymphomatoid granulomatosis, posttransplant lymphoproliferative disorders, acquired immunodeficiency syndrome (AIDS)-related lymphoma, and intravascular lymphoma/lymphomatosis. These lesions are best evaluated with multidetector chest computed tomography. The radiologic findings of the primary lymphoid lesions are often nonspecific and are best interpreted in correlation with clinical data and pathologic findings. The purpose of this article is to review pulmonary lymphoid anatomy as well as the most common primary pulmonary lymphoid disorders.
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Affiliation(s)
- Arlene Sirajuddin
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Kirtee Raparia
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Vanessa A Lewis
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Teri J Franks
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Sabeen Dhand
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Jeffrey R Galvin
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
| | - Charles S White
- From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724-5067 (A.S.); Departments of Pathology (K.R.) and Radiology (V.A.L., S.D.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, Md (T.J.F.); Departments of Diagnostic Radiology (Chest Imaging) and Internal Medicine (Pulmonary/Critical Care), University of Maryland School of Medicine, Baltimore, Md (J.R.G., C.S.W.); and American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.)
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Zhu J, Wang Y, Gong L, Huang G. Diagnosis of primary pulmonary T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia via clinicopathological observation and molecular assay. Diagn Pathol 2014; 9:188. [PMID: 25273521 PMCID: PMC4207321 DOI: 10.1186/s13000-014-0188-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 09/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Primary pulmonary lymphoma (PPL) is rare and easily misdiagnosed because of the lack of typical clinical features. It most commonly involves elderly patients aged between 60 and 70 years, and pathological diagnosis depends mainly on chest surgery rather than bronchial mucosal biopsy. Via percutaneous needle aspiration biopsy of the lung of a 33-year-old woman, which had distinct tissue eosinophilia, we diagnosed a rare case of rapidly growing large B cell lymphoma. Methods Bronchial mucosal biopsy and computed tomography–guided percutaneous needle aspiration biopsy were performed to determine the nature of the lesion, and we identified its immunophenotype using immunohistochemistry. We used BIOMED-2 gene rearrangement PCR to determine lymphocyte clonality; laser microdissection was used to confirm the clonality of suspicious malignant lymphocytes. Results Morphologically, the lesion was composed of a large number of eosinophilic cells and a few lymphoid cells. Immunohistochemical staining revealed a few CD1α-positive cells, but they were S-100–negative. The small lymphoid cells predominantly expressed CD3; the large lymphoid cells expressed CD20 and some scattered large lymphoid cells expressed Pax5. However, molecular studies confirmed clonal immunoglobulin heavy chain (IGH)-D gene rearrangement in Pax5–positive large B lymphocytes. Conclusions This is the first recorded case of T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia of the lung. It highlights the unusual morphological features of PPL that might be mistaken for eosinophilic granuloma or parasitic infection. In addition, IGH and T cell receptor gene rearrangement play important roles in differentiating rare B cell lymphoma from lung space–occupying lesions with abundant eosinophils or T cell infiltration. Virtual Slides The virtual slide(s) for this article can be found here: http://med.motic.com/MoticGallery/Slides/AC5C9A6F-46EC-4C71-A448-1312F6900C65?user=2C69F0D6-A478-4A2B-ABF0-BB36763E8025
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Abstract
A 28-year-old woman of Laotian origin presented with dry cough, fevers, night sweats and weight loss over the preceding 6 weeks. Radiological investigations revealed large complex cavitary lesions in the middle and lower lobes of the right lung, with no mediastinal lymph node enlargement. Bronchoscopic investigations did not yield a diagnosis. CT-guided fine-needle aspiration raised the possibility of Langerhans cell histiocytosis. Open lung biopsy initially supported this, but eventually a microscopic and immunohistochemical diagnosis of Hodgkin's lymphoma was made. The final diagnosis was primary pulmonary Hodgkin's lymphoma. We present a new case as well as a literature review of reported cases published since 2006.
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Affiliation(s)
- Nathania Cooksley
- Department of Thoracic Medicine, Cairns Hospital, Cairns, Queensland, Australia
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de Campos FPF, Felipe-Silva A, Zerbini MCN, Martines JADS. Primary diffuse large B-cell lymphoma or lymphomatoid granulomatosis grade 3: a still-puzzling diagnosis in autopsy. Autops Case Rep 2013; 3:29-36. [PMID: 28584804 PMCID: PMC5453658 DOI: 10.4322/acr.2013.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 12/05/2013] [Indexed: 12/02/2022] Open
Abstract
Primary lung lymphoma is a rare entity accounting for approximately 0.3% of all primary neoplasia of the lung and includes diffuse large B-cell lymphoma (DLBL) and lymphomatoid granulomatosis (LYG). Considering that clinical features may be similar, whereas epidemiology, morphology, and radiological features are different, the authors report a case of a middle-aged man who presented multiple pulmonary nodules in the lower lobes and ground-glass opacities scattered bilaterally on computed tomography. Clinically, he presented a consumptive syndrome with respiratory failure and pleurisy, which progressed until death. The autopsy findings were consistent with lymphomatoid granulomatosis (LYG) grade 3/ diffuse large B-cell lymphoma (DLBL). The authors call attention to the difficulty of establishing an accurate diagnosis, mainly when the demonstration of EBV-infected atypical B-cells fails.
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Affiliation(s)
| | - Aloísio Felipe-Silva
- Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
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