Analysis of Clinical Features, Pathological Features and Misdiagnosis of Pulmonary Lymphoma

Primary pulmonary lymphoma is a relatively rare extranodal lymphoma, and the incidence rate has increased in recent years. In the past, the disease mainly relied on surgery to obtain the pathological basis, so the clinical misdiagnosis rate was high. How to improve its early diagnosis and treatment has attracted much attention. By exploring the imaging manifestations of primary pulmonary lymphoma, we can further understand and improve the imaging diagnosis level of primary pulmonary lymphoma. This paper discusses the classification, imaging manifestations, diagnosis and identification of pulmonary lymphoma. The clinical data and imaging findings of primary pulmonary lymphoma diagnosed in a hospital were retrospectively summarized, and their imaging features were analyzed. We observe the clinicopathological characteristics and immunohistochemical phenotypes of multiple masses with cavitation type primary lung lymphoma, and analyze the virus and imaging characteristics of hybridization. The results of the study show that the CT (Computed Tomography) manifestations of primary lung lymphoma are diverse. The characteristics of cross-leaf distribution are more characteristic, and enhanced scanning lesions are usually mild to moderate. In the case of simultaneous masses and pneumonialike consolidation in the lungs, this disease needs to be considered.

A Retrospective Study on Clinical Significance of Imaging And Endobronchial Features In Pulmonary Lymphoma Diagnosed By Bronchoscopy: When Should We Perform Bronchoscopy?

Background: Pulmonary lymphoma is rare while the radiographic lesions are nonspecific. The use of bronchoscopy, is controversial, and may be of limited diagnostic value for pulmonary lymphoma diagnosis.Methods: Cases of pulmonary lymphoma diagnosed by bronchoscopy were retrospectively reviewed from January 2010 till December 2020. Clinico-radiological records of these cases were retrieved and bronchoscopy was performed with histopathological evaluation of the biopsy specimens. Results: Of the 41 cases included in our study, 20 were primary pulmonary lymphoma. The majority of subtypes were diffuse large B-cell lymphoma(43.9%) and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue lymphoma(29.3%), with high percentage of underlying chronic disease. The common Computed Tomography(CT) abnormalities were mass(43.9%), consolidation(24.4%) or ground-glass opacities(24.4%). To evaluate the pulmonary lesions distribution, 41.5% patients had segmental lesions, 29.3% presences of diffuse lesions, 17.1% of local lesions and 12.2% of hilar lesions, with the maximal value of standard uptake value (SUVmax) median value of 9.6. At bronchoscopy, 41.5% lesions were identified as focal solitary mass, 22% were normal, 17.1% were mucosae asperity or edema, 9.8% were diffuse airway submucosal nodules or thickening and 9.8% were bronchiole stenosis, while certain endobronchial patterns may correspond to specific imaging features. Conclusion: The imaging features and endobronchial patterns of pulmonary lymphoma are characteristic. Bronchoscopy is still a useful tool, that is minimally invasive, to diagnose pulmonary lymphoma, while accurate analysis of the clinico-radiological records is essential before such procedure.

Hammering home the sickle: an instructive case of endobronchial anaplastic large cell lymphoma

It is extremely unusual for primary pulmonary lymphoma, an uncommon occurrence in any form, to be of T-cell origin and to manifest as an endobronchial lesion. Each of these characteristics is rare individually, so cases that combine them are exceptional. We report a patient in whom primary pulmonary anaplastic large cell lymphoma, a T-cell neoplasm, presented with obstruction of the left upper lobe bronchus, resulting in left upper lobe atelectasis and creating the radiographic luftsichel sign. We briefly discuss anaplastic large cell lymphoma as a whole, place our case in the context of previously published literature on endobronchial anaplastic large cell lymphoma, and review the genesis of the luftsichel sign.

Primary pulmonary lymphoma presenting as nodules and masses: a case report and literature review

Primary pulmonary lymphoma (PPL) is a rare neoplasm. We report a case of 45-year-old men who was admitted to hospital for multiple nodules and masses in both lungs. The contrast enhanced chest CT scans revealed multiple nodules and masses of varying sizes in right upper and middle lobes and both lower lobes. CT-guided percutaneous transthoracic needle biopsy was performed. The diagnosis of PPL was confirmed by histopathological examination and Immunohistochemical staining. PPL should be included in the differential diagnoses in symptomless patients with multiple pulmonary nodules and masses.