Department of Radiology, Hospital Universitario La Paz, Paseo de La Castellana, Madrid, Spain.
Br J Radiol. 2011 Dec;84(1008):e229-31. doi: 10.1259/bjr/28699097.
Primary pleural lymphoma is a rare entity that has been described in association with human immunodeficiency virus (HIV) infection or pyothorax. It occurs in only 7% of primary lymphoma cases. We report the case of a 52-year-old male with no history of HIV infection or pyothorax who was diagnosed of obstructive sleep apnoea syndrome (OSAS) and underwent a routine chest X-ray to screen for any organic cause of the symptoms. The radiograph revealed two voluminous masses with extraparenchymatous features but without pleural effusion. A contrast-enhanced CT was performed and confirmed the existence of the pleural masses that showed homogeneous attenuation. Neither mediastinal lymphadenopathy nor pleural effusion were present. A percutaneous CT-guided fine needle aspiration cytology (FNAC) with a 25-G needle was performed (two samples were obtained) and the first diagnosis was of non-Hodgkin's lymphoma. The final diagnosis of primary pleural mucosa-associated lymphoid tissue (MALT) lymphoma was confirmed by a CT-guided core biopsy with a 20-G needle. To the best of our knowledge, no cases of MALT lymphoma presenting as pleural masses without pleural effusion have been reported in immunocompetent patients. In this report, we describe the case of a patient with a primary pleural MALT lymphoma and include a short review of the literature.
原发性胸膜淋巴瘤是一种罕见的疾病，与人类免疫缺陷病毒（HIV）感染或脓胸有关。它仅占原发性淋巴瘤病例的 7%。我们报告了一例 52 岁男性病例，无 HIV 感染或脓胸病史，被诊断为阻塞性睡眠呼吸暂停综合征（OSAS），并进行了常规胸部 X 线检查以筛查症状的任何器质性原因。X 线片显示两个体积较大的肿块，具有肺外特征，但没有胸腔积液。进行了增强 CT 检查，证实存在胸膜肿块，呈均匀衰减。纵隔淋巴结肿大和胸腔积液均不存在。进行了经皮 CT 引导下 25-G 针细针抽吸细胞学检查（获得两个样本），最初诊断为非霍奇金淋巴瘤。经 CT 引导下 20-G 针芯活检最终确诊为原发性胸膜黏膜相关淋巴组织（MALT）淋巴瘤。据我们所知，在免疫功能正常的患者中，没有报告过表现为无胸腔积液的胸膜肿块的 MALT 淋巴瘤病例。在本报告中，我们描述了一例原发性胸膜 MALT 淋巴瘤患者，并对文献进行了简短回顾。
