title: Role of surgery in the treatment of primary pulmonary B-cell lymphoma.
abstract: BACKGROUND
  The purpose of this study was to define the role of surgery in the treatment of primary pulmonary lymphoma (PPL).
  
  
  METHODS
  We reviewed all patients presenting with a pathologic diagnosis of PPL in our institution during the past 20 years. We analyzed the outcome and determined the impact of complete versus incomplete surgical resection on survival.
  
  
  RESULTS
  The study included 17 patients with PPL confined to the pulmonary parenchyma. Pathologic diagnosis was low-grade B-cell PPL in 14 patients, high-grade B-cell PPL in 2, and lymphomatoid granulomatosis in 1. A complete resection was performed in 8 patients presenting with low-grade B-cell PPL and in 2 patients with high-grade B-cell PPL. The overall survival of patients presenting with low-grade B-cell PPL was 63% at 10 years; however, survival at 10 year tended to be better when a complete resection was performed (87.5% vs 25%, respectively; p = 0.08). Gender, bilateral disease, or adjuvant therapy did not affect survival. Both patients presenting with high-grade B-cell PPL are alive and free of disease 22 and 36 months after the surgery, respectively. The patient presenting with lymphomatoid granulomatosis is alive after 2 years of follow-up.
  
  
  CONCLUSIONS
  PPL is a rare disease that may be localized or diffuse in one or both lungs. Surgery should be the treatment of choice in the localized form of PPL if complete resection can be achieved. A complete resection is associated with an excellent long-term survival of almost 90%. If the lesions are diffuse or involve both lungs, medical therapy should then be the treatment of choice.
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Vanden Eynden
authors.forename: Elie
authors.initials: E
authors.lastname: Fadel
authors.forename: Marc
authors.initials: M
authors.lastname: de Perrot
authors.forename: Vincent
authors.initials: V
authors.lastname: de Montpreville
authors.forename: Sacha
authors.initials: S
authors.lastname: Mussot
authors.forename: Philippe
authors.initials: P
authors.lastname: Dartevelle
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D016393:Lymphoma, B-Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed