Primary pulmonary lymphoma.
BACKGROUND
Primary pulmonary lymphoma is a rare disease. The clinical characteristics, methods of treatment, and outcomes are not well elucidated.


METHODS
A retrospective review of primary pulmonary lymphoma cases at a single institution from 1990 to 2002 was performed.


RESULTS
Eighteen patients were included, with a mean follow-up of 2.9 years. Fourteen patients had mucosa-associated lymphoid tissue (MALT) lymphoma, 2 had large cell transformation of sheet cells in MALT lymphoma, and 1 each had Hodgkin's disease and follicular lymphoma. Computed tomography-guided biopsy was diagnostic in only two of eight attempts. Eleven patients had disease confined to the pulmonary parenchyma, and 7 had parenchymal disease as well as mediastinal lymphadenopathy. Treatment methods included observation only (n = 1), surgery only (n = 6), surgery plus chemotherapy (n = 8), surgery plus radiotherapy (n = 1), and surgery plus chemotherapy plus radiotherapy (n = 2). Kaplan-Meier estimate of median time to disease recurrence or death was 6 years. Only 1 patient died of disease-related causes. Patients who had bilateral disease were more likely to have recurrent disease or death (p = 0.03).


CONCLUSIONS
A wide range of treatments were used for patients with generally MALT lymphoma, resulting in good outcomes, and recurrent disease was well controlled.
Graham
Brian B
BB
Department of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA. brian.graham@uchsc.edu
Mathisen
Douglas J
DJ
Mark
Eugene J
EJ
Takvorian
Ronald W
RW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008223:Lymphoma / Q000175:diagnosis* / Q000628:therapy*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome