Clinical Analysis Of 27 Cases Of Primary Pulmonary Lymphoma

Objective To improve the understanding of primary pulmonary lymphoma(PPL),we analyze the clinical manifestation,imaging,pathology,diagnosis,treatment and prognosis features of 27 cases of PPL.Methods Clinical data of 27 PPL patients diagnosed in the First Affiliated Hospital of Soochow University from January 2000 to December 2016 are collected and analyzed.Results There are 16 males and 11 females,the average age is 54.6±15.7 years.The main manifestations are cough(n = 12),expectoration(n = 6),sputum with blood(n = 5),chest pain(n = 2),chest tightness(n = 3),fever(n = 4),night sweats(n = 1),and 9 patients have no obvious clinical symptoms.Unilateral lung involvement is common,and there is no significant difference in lung lobe distribution.2 cases are pulmonary Hodgkin's lymphoma(PHL),18 cases are pulmonary non-Hodgkin's lymphoma(PNHL),7 cases are undifferentiated lymphoma.NHL included 2 cases of T cell lymphoma,11 cases of mucosa-associated lymphoid tissue(MALT)lymphoma,3 cases of diffuse large B-cell lymphoma(DLBCL),1 case of small B cell lymphoma and 1 case of plasmacytoid B cell lymphoma.The imaging findings are shown as: nodular masses:(solitary mass in 17 cases and multiple nodules in 4 cases),pneumonia or consolidation changes:(involved 1lobe in 1cases,? 2 lobes in 3 cases),2 cases of mixed type.Up to March 2017,11 patients survived(10 cases were MALT lymphoma and 1 patient of DLBCL survived without progression 71 months after chemotherapy).The correlation between international prognostic index(IPI)of non-Hodgkin's lymphoma and prognosis of PNHL is statistically significant(P=0.018).Conclusions The clinical manifestations and imaging features of PPL are non-specific.No specific lobe distribution is found.The prognosis of MALT lymphoma is better than other types,DLBCL is an aggressive tumor,but early diagnosis and chemotherapy can achieve complete remission and long-term survival.IPI can predict the prognosis of PNHL.