title: Primary pulmonary lymphoma: diagnosis and follow-up of 6 cases and review of an uncommon entity.
abstract: OBJECTIVE
  Primary pulmonary lymphoma is an uncommon disease with a poorly defined management. We reviewed and followed the cases of primary pulmonary lymphoma in our institution to gather an estimation of this entity in our population.
  
  
  METHODS
  We reviewed the records of all patients with biopsy-proven lymphoma of the lung. The main diagnostic criterion for primary pulmonary lymphoma was the absence of extrapulmonary involvement.
  
  
  RESULTS
  We identified 6 cases of primary pulmonary lymphoma among 33 patients with biopsy-proven lymphoma of the lung evaluated in our center in a 12-year period. A radiological abnormality in an asymptomatic patient was the most common clinical presentation. Four cases were low-grade and two cases high-grade non-Hodgkin PPL. Histopathologic analyses of lung specimens obtained by transbronchial biopsy were sufficient for a diagnosis in 5 of the 6 cases and avoided invasive surgical maneuvers. Most patients followed an indolent course, but with a tendency to relapse.
  
  
  CONCLUSIONS
  Although clinical management of this entity is undefined, we feel bronchoscopic study, which is less aggressive than surgery, may be an adequate procedure for a diagnosis. Mono-chemotherapy using alkylating agents and careful clinical observation may be the best therapeutic approach for these patients, since most of them have favorable outcomes, whatever the treatment modalities.
authors.affiliation: Internal Medicine, University Hospital 12 De Octubre, Madrid, Spain. jfva_varona@yahoo.com
authors.forename: Jose Felipe
authors.initials: JF
authors.lastname: Varona
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Guerra
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Victoria
authors.initials: V
authors.lastname: Villena
authors.forename: Carmen
authors.initials: C
authors.lastname: González-Lois
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martínez
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating