Tang Victoria K, Vijhani Praveen, Cherian Sujith V, Ambelil Manju, Estrada-Y-Martin Rosa M
Department of Internal Medicine, Divisions of Critical Care, Pulmonary and Sleep Medicine, UT Health- McGovern Medical School, Houston, Texas, USA.
Department of Pathology and Laboratory Medicine, UT Health- McGovern Medical School, Houston, Texas, USA.
Lung India. 2018 May-Jun;35(3):220-230. doi: 10.4103/lungindia.lungindia_381_17.
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.
肺淋巴增殖性肿瘤是罕见的肺部肿瘤,占所有肺部肿瘤的比例不到1%。其中,原发性肺淋巴瘤(PPL)占大多数,包括非霍奇金淋巴瘤(NHL),后者由黏膜相关淋巴组织淋巴瘤、弥漫性大B细胞淋巴瘤以及其他罕见类型的NHL和淋巴瘤样肉芽肿组成。HL是PPL中最罕见的类型,它继发于纵隔的连续性扩散。肺淋巴增殖性肿瘤范畴内描述的其他实体包括胸膜淋巴瘤和移植后淋巴增殖性疾病(PTLD)——发生于干细胞和器官移植后的患者。这些肿瘤虽然罕见,但预后良好,其预后并不取决于疾病的可切除性。此外,由于其表现不具有特异性,诊断具有挑战性,这在许多情况下常常导致诊断延迟或误诊。因此,了解这一实体对执业肺科医生很重要。这篇综述文章旨在描述主要是PPL内的实体以及胸膜淋巴瘤和PTLD的临床表现、诊断和管理。