Kim Jung Han, Lee Se-Hoon, Park Jinny, Kim Ho Young, Lee Soon Il, Park Joon-Oh, Kim Kihyun, Kim Won Seog, Jung Chul Won, Park Young Suk, Im Young-Hyuck, Kang Won Ki, Lee Mark H, Park Keunchil, Han Joung Ho, Ko Young Hyeh
Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 135-710 Seoul, Korea.
Jpn J Clin Oncol. 2004 Sep;34(9):510-4. doi: 10.1093/jjco/hyh095.
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.
We reviewed the medical records of 24 patients who were pathologically and clinically diagnosed as primary pulmonary lymphoma between September 1995 and June 2003.
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.
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.
原发性肺非霍奇金淋巴瘤是一种非常罕见的肿瘤。最常见的表现为黏膜相关淋巴组织（MALT）型边缘区B细胞淋巴瘤。尽管已有一些关于这种淋巴瘤的综述，但临床特征、诊断方法、最佳治疗方案和预后因素尚未明确界定。
我们回顾了1995年9月至2003年6月期间24例经病理和临床诊断为原发性肺淋巴瘤患者的病历。
13例为MALT淋巴瘤，2例为MALT淋巴瘤合并大B细胞淋巴瘤，7例为弥漫性大B细胞淋巴瘤，2例为间变性大细胞淋巴瘤。半数患者就诊时无症状；46%有呼吸道症状，16.7%有B症状。初始影像学表现多样，包括结节、肿块、浸润或实变。大多数患者（66.7%）需要手术（开胸或电视辅助胸腔镜手术）来明确诊断。83%的患者接受了支气管镜检查，但只有30%的检查有诊断结果。13例MALT淋巴瘤患者接受了多种治疗方式，如观察、手术及单药或联合化疗，11例非MALT淋巴瘤患者无论是否手术均接受了联合化疗。24例患者的3年总生存率为86%，中位随访时间为32个月。
尽管这种淋巴瘤似乎预后良好，但仍需要进一步的临床经验和长期随访来确定预后因素。
