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Japanese Journal of Clinical Oncology 2004 34(9):510-514; doi:10.1093/jjco/hyh095
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© 2004 Foundation for Promotion of Cancer Research

Primary Pulmonary Non-Hodgkin's Lymphoma

Jung Han Kim1, Se-Hoon Lee1, Jinny Park1, Ho Young Kim1, Soon Il Lee1, Joon-Oh Park1, Kihyun Kim1, Won Seog Kim1, Chul Won Jung1, Young Suk Park1, Young-Hyuck Im1, Won Ki Kang1, Mark H. Lee1, Keunchil Park1, Joung Ho Han2 and Young Hyeh Ko2

1 Division of Hematology/Oncology, Department of Medicine and 2 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

For reprints and all correspondence: Kihyun Kim, Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Ilwon-Dong 50, Gangnam-Gu, 135–710, Seoul, Korea. E-mail: kihyunk{at}smc.samsung.co.kr

Received March 22, 2004; accepted June 3, 2004

Background: Primary pulmonary non-Hodgkin's lymphoma is a very rare neoplasm. It is represented most commonly by marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. Although there have been a few reviews of this lymphoma, clinical features, diagnostic procedure, optimal management and prognostic factors have not been well defined.

Methods: We reviewed the medical records of 24 patients who were pathologically and clinically diagnosed as primary pulmonary lymphoma between September 1995 and June 2003.

Results: There were 13 patients with MALT lymphoma and two with MALT lymphoma accompanied by large B-cell lymphoma, seven with diffuse large B-cell lymphoma and two with anaplastic large cell lymphoma. Half the patients were asymptomatic at presentation; 46% had respiratory symptoms and 16.7% had B-symptoms. Initial radiological findings were variable including nodules, masses, infiltrates or consolidation. The majority of patients (66.7%) needed surgical approaches (open thoracotomy or video-assisted thoracoscopy) for definite diagnosis. Bronchoscopy was performed in 83%, but only 30% showed a diagnostic yield. The 13 patients with MALT lymphoma were treated with a variety of modalities such as observation, surgery and single or combination chemotherapy, and combination chemotherapy was administered to 11 patients with non-MALT lymphoma regardless of surgery. The overall survival rate at 3 years for all 24 patients was 86% with a median follow-up of 32 months.

Conclusion: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify prognostic factors.

Key Words: lung • MALT lymphoma • non-Hodgkin's lymphoma


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