Clinical Analysis Of Primary Pulmonary Lymphoma

Objective:Discuss the clinical feature, imaging and pathological characteristics of different pathological types of primary pulmonary lymphoma, to enhance the systemic knowledge of such disease, and to elevate the accuracy of diagnosis and differential diagnosis.Methods:Collect36cases of primary pulmonary lymphoma diagnosed via pathology and IHC in the First Affiliated Hospital of Zhejiang University School of Medicine from Feb.2007to Apr.2013, retrospective conclude patients’clinical and imaging material, analyze the clinical feature, imaging feature, pathological feature and diagnosis, and compare the two most common type of primary pulmonary lymphoma, MALT lymphoma and diffused large B cell lymphoma, by Pearson test.Results:Within the36cases of PPL, there are2Hodgkin Lymphoma cases and34Non-Hodgkin Lymphoma cases. Within the34NHL cases, there are25cases of MALT,6cases of diffused large B cell lymphoma,1case of T lymphoblastic lymphoma and2cases of NK/T cell lymphoma. In conclusion, PPL’s clinical features lack specificity, the most common symptoms are cough, fever and weight loss. The imagine showed single or multiple consolidation shadow or mass shadow, more commonly seen in the right lung, especially in the middle lobe of right lung, most of which are consolidation shadow, while in the left lung the mass shadows are more common. Air bronchogram can be seen in most of the lesions, and the straddling-lobe distribution of the lesions are specified, the lesions are mild-medium enhanced under contrast CT scan, hilar and mediastinum lymph node could be enlarged, unilateral or bilateral pleural effusion or multi serum cava effusion could also be seen. There is no significant difference of gender ratio between MALT lymphoma and diffused large B cell lymphoma, the clinical features are similar, and there is no specific clinical feature to distinguish. In the CT scan, diffused large B cell lymphoma tends to become cavity than MALT lymphoma. The most pleural effusion of MALT patients are unilateral, while that of non-MALT patients tend to be bilateral, or even multiple serum cava effusion. The bronchofiberscope check is generally negative, while the diffused large B cell lymphoma tends to be easy to get intra-trachea lesion, so the bronchofiberscope check is effective. But in general, the CT guided percutaneous lung biopsy is more valuable.Conclusion:The clinical features of primary pulmonary NHL are nonspecific, but the CT image showed some characteristics. The MALT and diffused large B cell lymphoma show no obvious difference in human group and clinical features, but they are different in clinical imagine. The CT guided percutaneous lung biopsy is valuable in diagnosis of PPL, while the positive rate of diagnosis by bronchofiberscope is low.