Toyohara Katsushi, Ishihara Hiroya, Morita Takuro, Shindo Yuki, Takeda Sho, Fumimoto Satoshi, Ochi Kaoru, Ichihashi Yoshio, Sato Kiyoshi, Kuwabara Hiroko, Hanaoka Nobuharu, Katsumata Takahiro
Department of Thoracic Surgery, Hirakata Municipal Hospital, Osaka, Japan.
Department of Thoracic Surgery, Kishiwada City Hospital, Osaka, Japan.
Gen Thorac Cardiovasc Surg Cases. 2025 May 9;4(1):24. doi: 10.1186/s44215-025-00208-3.
Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma and idiopathic lymphocytic interstitial pneumonia (iLIP) are rare pulmonary diseases. MALT lymphoma is an extranodal marginal zone lymphoma (EMZL), whereas LIP is a benign lymphoproliferative disorder characterized by lymphocytic infiltration of the lungs. LIP should be closely monitored, as it has the potential to undergo malignant transformation into MALT lymphoma.
A 45-year-old woman was diagnosed with LIP and followed up for 9 years before being referred to our hospital due to an enlarging shadow on chest radiographs. The volume of the sample collected via bronchoscopy was too small to make a diagnosis, so the patient underwent surgery. The pathology results revealed diffuse proliferation of medium-sized lymphocytes filling the alveolar spaces, leading to a diagnosis of MALT lymphoma. After a thorough examination, no other lesions were found, confirming the diagnosis of EMZL of the lung, a primary pulmonary lymphoma (PPL). No postoperative treatment was administered after surgery; however, 2 years later, recurrence was detected in the stomach, and the patient underwent chemotherapy. Complete remission was achieved through chemotherapy, and the patient has been recurrence-free for 3 years since her treatment.
We report a rare case of MALT lymphoma that developed 9 years after the diagnosis of LIP. Since LIP can undergo malignant transformation into EMZL, it is important to be aware of this possibility. Differentiating between the two diseases onthe basis ofclinical and imaging findings is challenging, so biopsytechniques, such as transbronchial biopsy, CT-guided needle aspiration biopsy, and surgical resection, are essential. While surgery is the standard treatment for primary pulmonary lymphoma, observation is a viable option, as it provides results comparable to those of other treatment approaches.
肺黏膜相关淋巴组织（MALT）淋巴瘤和特发性淋巴细胞间质性肺炎（iLIP）是罕见的肺部疾病。MALT淋巴瘤是一种结外边缘区淋巴瘤（EMZL），而淋巴细胞间质性肺炎是一种良性淋巴增殖性疾病，其特征是肺部淋巴细胞浸润。淋巴细胞间质性肺炎应密切监测，因为它有可能恶变为MALT淋巴瘤。
一名45岁女性被诊断为淋巴细胞间质性肺炎，并随访了9年，之后因胸部X线片上阴影增大而转诊至我院。通过支气管镜采集的样本量太小，无法做出诊断，因此患者接受了手术。病理结果显示中等大小淋巴细胞弥漫性增殖，充满肺泡腔，从而诊断为MALT淋巴瘤。经过全面检查，未发现其他病变，确诊为肺EMZL，即原发性肺淋巴瘤（PPL）。术后未进行任何治疗；然而，2年后，胃部出现复发，患者接受了化疗。化疗后实现了完全缓解，自治疗以来患者已无复发3年。
我们报告了一例罕见的MALT淋巴瘤病例，该病例在淋巴细胞间质性肺炎诊断9年后发生。由于淋巴细胞间质性肺炎可恶变为EMZL，因此了解这种可能性很重要。根据临床和影像学表现区分这两种疾病具有挑战性，因此活检技术，如经支气管活检、CT引导下针吸活检和手术切除，至关重要。虽然手术是原发性肺淋巴瘤的标准治疗方法，但观察也是一种可行的选择，因为它提供的结果与其他治疗方法相当。
