Yu Lee-Mateus Alejandra, Garcia-Saucedo Juan C, Abia-Trujillo David, Khoor Andras, Fernandez-Bussy Sabastian
Pulmonary Medicine, Mayo Clinic, Jacksonville, USA.
Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, USA.
Cureus. 2021 Feb 3;13(2):e13104. doi: 10.7759/cureus.13104.
Endobronchial tumors (ET) are unusual and mostly malignant, presenting with non-specific symptoms that often delay appropriate diagnosis and treatment. Lymphomas in the airway represent less than 1% of pulmonary malignancies and require multidisciplinary approach for their management. We present a case of a 48-year-old male former smoker with a one-year history of recurrent respiratory infections and new-onset shortness of breath. Diagnostic tests included a chest computed tomography (CT) reporting the presence of an endobronchial mass and neck and cervical lymph node biopsies with inconclusive results. Bronchoscopy was successfully performed for tumor resection, improving the patient's respiratory symptoms. Histological analysis described an extranodal marginal zone B-cell lymphoma (ENMZL) with plasmacytic differentiation; a subtype of non-Hodgkin's lymphoma (NHL) in mucosa-associated lymphoid tissue (MALT), rarely found as an endobronchial growth. ET should be considered in the setting of persistent and worsening respiratory symptoms. ENMZL with plasmacytic differentiation is rarely found as an ET and diagnosis requires bronchoscopic intervention and extensive immunohistochemical analysis.
支气管内肿瘤（ET）较为罕见，且大多为恶性，表现为非特异性症状，常常延误恰当的诊断和治疗。气道淋巴瘤占肺部恶性肿瘤的比例不到1%，其治疗需要多学科方法。我们报告一例48岁男性既往吸烟者，有一年反复呼吸道感染病史及新发气短症状。诊断检查包括胸部计算机断层扫描（CT）显示存在支气管内肿块，以及颈部和锁骨上淋巴结活检，结果不明确。成功进行了支气管镜肿瘤切除术，改善了患者的呼吸道症状。组织学分析显示为伴有浆细胞分化的结外边缘区B细胞淋巴瘤（ENMZL）；这是黏膜相关淋巴组织（MALT）中非霍奇金淋巴瘤（NHL）的一种亚型，很少以内支气管生长形式出现。在持续且加重的呼吸道症状情况下应考虑ET。伴有浆细胞分化的ENMZL很少以内支气管肿瘤形式出现，诊断需要支气管镜干预及广泛的免疫组化分析。
