Colby T V, Carrington C B
Am J Surg Pathol. 1982 Jan;6(1):19-32. doi: 10.1097/00000478-198201000-00002.
Twenty cases of malignant lymphoma presenting in the lung and 10 cases with secondary pulmonary involvement were studied. All cases shared the feature of prominent vascular infiltration by lymphoid cells, and in the 20 cases presenting with pulmonary involvement, this feature led to confusion with lymphomatoid granulomatosis. Both the primary and secondary lymphomas showed similar histologic features including vascular infiltration, extensive necrosis, and foci of a histologically polymorphous and benign infiltrate. The diagnosis of lymphoma was based on the identification of monomorphous foci of atypical lymphoid cells except in the cases of Hodgkin's disease. The malignant cells were occasionally focal and microscopic and surrounded by an extensive histologically benign infiltrate. Examination of several blocks was often required in such cases before a diagnosis of lymphoma could be made. The clinical and radiologic findings at presentation were nonspecific. Radiologic findings included unilateral or bilateral nodules and infiltrates. The prognosis of the 20 patients who presented with pulmonary lymphoma was poor; half were dead in less than 2 years.
对20例以肺部表现为主的恶性淋巴瘤患者及10例继发肺部受累的患者进行了研究。所有病例均具有淋巴细胞显著浸润血管的特征，在20例肺部受累的病例中，这一特征导致与淋巴瘤样肉芽肿病相混淆。原发性和继发性淋巴瘤均表现出相似的组织学特征，包括血管浸润、广泛坏死以及组织学上多形性和良性浸润灶。淋巴瘤的诊断基于除霍奇金病外非典型淋巴细胞单形性病灶的识别。恶性细胞偶尔呈局灶性且微小，被广泛的组织学良性浸润所包围。在这类病例中，通常需要检查多个组织块才能做出淋巴瘤的诊断。就诊时的临床和影像学表现无特异性。影像学表现包括单侧或双侧结节及浸润影。20例肺部淋巴瘤患者的预后较差；半数患者在不到2年的时间内死亡。
