Analysised Five Cases Of Primary Pulmonary Lymphoma And Reviewed The Literature

Objective To study the clinical features of primary pulmonary lymphoma (including symptoms, signs, imaging findings, pathology, ect.) for improving the diagnostic rate.Method Five cases of primary pulmonary lymphoma diagnosed at The First Affiliated Hospital of Guangxi Medical University from December 2000 to December 2010 were retrospectively analyzed, and the literature was reviewed with regard to its clinical manifestations, laboratory tests, imaging findings, pathological charasteristics, diagnosis and treatment.Result (1) Male to female ration is 4:1. Their average age was 56.4 years old. Three cases had chronic onset. One case had acute onset and the other was found by medical examination. All patients had no special medical history and drug exposure. (2) Main symptoms were cough and expectoration (4/5), hemoptysis (4/5), chest pain (3/5), dyspnea (2/5). (3) Laboratory results: one patient had anemia, decreased serum albumin, elevated serum LDH and decreased serum IgM. The other tests were normal. (4) Bronchoscopy revealed mucosal congestion and edema (3/3), stenosis (2/3), polyp (1/3); lung function test was normal (3/4) or mild ventilatory dysfunction (1/4). (5) CT features: The lesions involved unilateral (3/5) or bilateral (2/5) of the lung. Involvement of Lower lobe was common(5/5). The major finding was patchy (3/5), nodule or mass (3/5), consolidation (2/5). Two cases showed air bronchogram (2/5). (6) All of them was misdiagnosed. The final diagnosis depended on TBLB (2/5) or thoracotomy (3/5); (7) All of the cases were non-Hodgkin's lymphoma, including three MALT lymphoma (3/5), one diffuse large B-cell lymphoma (1/5), one lymphomatoid granulomatosis (1/5). Four cases were Stageâ…¡E and the left one was Stageâ… E. (8) One patient without treatment died after three months. Three of the four patients who accepted surgery resection plus chemotherapy were still alive, while the other one was out of watching.Conclusions (1) Primary pulmonary lymphoma happens in the elderly men more common. It usually gets insidious onset and slow progression. (2) The main clinical manifestations are cough, expectoration and hemoptysis. (3) X-ray features includ nodule, mass, patchy or consolidation. Bronchoscopy reveals lumina changes. (4) Misdiagnosis is common. The final diagnosis depends on pathology. (5) MALT lymphoma is the most common type. It is usually Stageâ… E or Stageâ…¡E. Treatment modalities include surgical resection and chemotherapy. The prognosis is favorable.