Prognostic factors of Chinese patients with primary pulmonary non-Hodgkin's lymphoma: the single-institute experience in Taiwan.
Primary pulmonary lymphoma (PPL) accounts for less than 1% of patients with non-Hodgkin's lymphoma, with no report in Chinese patients. This study aims to analyze the clinical features and prognosis of this population. Patients with biopsy-proven pulmonary lymphoma were reviewed and re-classified by a hema-pathologist. Between 1992 and 2005, a total of 22 patients were identified (16 men and six women), with a mean age of 70 years. The histological subtypes included marginal zone B-cell lymphoma of mucosa-associated lymphoid tissues (MALT) in 12 patients (54%), diffuse large B-cell lymphoma in nine (41%), and one case of lymphomatoid granulomatosis. Diseases mainly manifested as pulmonary nodules or masses in 73% of patients, with a higher rate of hilar/mediastinal lymphadenopathy in non-MALT patients (8% vs. 80%, P = 0.002). In eight patients (36% of 22), diagnoses were only conclusive until the biopsy via thoracotomy. Eighteen patients (82%) received chemotherapy. The 5-year rates of overall survival (OS) were 91% and 21% for MALT and non-MALT types of PPL, respectively. Patients who had received surgical resection tended to have a better 5-year OS rate (P = 0.077). The Cox-regression analysis showed that two factors -- elevated serum lactate dehydrogenase level and hilar/mediastinal lymphadenopathy at diagnosis -- were independently associated with a poor OS, with a hazard ratio of 10.370 and 5.171 (P = 0.01 and 0.033), respectively. In conclusion, the histological subtypes of Chinese PPL patients were similar to those in previous reports, with no increasing incidence of T-cell immunophenotype. The two prognostic factors provided additional information in managing these patients.
Hu
Yu-Hui
YH
Division of Hematology & Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Hsiao
Liang-Tsai
LT
Yang
Ching-Fen
CF
Chiou
Tzeon-Jye
TJ
Liu
Jin-Hwang
JH
Gau
Jyh-Pyng
JP
Yen
Chueh-Chuan
CC
Chou
Teh-Ying
TY
Hsu
Wen-Hu
WH
Chen
Po-Min
PM
Tzeng
Cheng-Hwai
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology