Objective Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type is the most frequent type of non-Hodgkin's lymphoma to ...
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ORIGINAL ARTICLE
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Clinicopathological Features of Patients with BronchialAssociated Lymphoid Tissue Lymphoma Hisao Imai 1,2, Noriaki Sunaga 1, Kyoichi Kaira 1, Osamu Kawashima 2, Noriko Yanagitani 1, Koji Sato 3, Yoshio Tomizawa 2, Takeshi Hisada 1, Tamotsu Ishizuka 1, Junko Hirato 4, Ryusei Saito 2, Takashi Nakajima 5 and Masatomo Mori 1
Abstract Objective Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type is the most frequent type of non-Hodgkin’s lymphoma to primarily involve the lung. Pulmonary MALT lymphoma, also known as bronchial-associated lymphoid tissue (BALT) lymphoma, is a rare disease and the clinicopathological features have yet to be clearly elucidated. Patients and Methods The present study retrospectively reviewed 13 patients (8 men, 5 women) with BALT lymphoma from 3 institutions between 1989 and 2007 to assess clinicopathological features. Results At diagnosis, the median age was 61.6 years (range, 37-80 years), and 11 patients were asymptomatic while 2 had non-specific pulmonary symptoms. Two patients had a history of Sjögren’s syndrome. Computed tomography of the chest revealed bilateral disease in 7 patients, lung nodules in 8 patients and air space consolidation with or without air bronchogram in 5 patients. In all cases, disease was localized within the lung at the initial diagnosis. Of the 13 patients, 5 remain untreated, while 8 received various combinations of treatment (surgery alone in 6 patients, surgery plus chemotherapy in 1 patient, and radiotherapy alone in 1 patient). Twelve patients remained alive during the median follow-up of 31.3 months (range, 2-147 months), while 1 patient died from unknown causes. Conclusion The present study indicates that BALT lymphoma tends to be limited to the lung on the initial diagnosis and responds well to local therapy such as surgery. Prognosis for this lymphoma tends to be indolent. Key words: BALT lymphoma, clinicopathological features, diagnosis, treatments, prognosis (Inter Med 48: 301-306, 2009) (DOI: 10.2169/internalmedicine.48.1438)
Introduction Primary pulmonary non-Hodgkin’s lymphoma (NHL), also known as bronchial-associated lymphoid tissue (BALT) lymphoma, is a rare extranodal lymphoma with low-grade B-cell types and is considered to originate from mucosaassociated lymphoid tissue (MALT) of the bronchus (1, 2). MALT lymphomas arise from numerous extranodal sites, usually in the setting of chronic local inflammatory disor-
ders or autoimmune diseases such as Sjögren’s syndrome. Extranodal marginal zone lymphoma (MZL) of the MALT type in the lungs arises from BALT, which is histologically distinct from true intrapulmonary lymph nodes (3). BALT lymphoma comprises more than two-thirds of all primary NHLs of the lung, and MZL represent a rare entity accounting for
