Pulmonary Lymphoma

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This entry looks at pulmonary lymphoma, a lymphoma subtype. 'Lymphoma' is an umbrella term that loosely refers to several dozen independent categorical types and subtypes of cancers of the lymphatic system.

What is pulmonary lymphoma?

Primary pulmonary lymphoma refers to a B-cell, non-Hodgkin lymphoma that develops as a single tumor mass in one or both lungs and is generally not found to have spread outside the lungs. It is sometimes misdiagnosed as either an abscess or as non-small cell lung cancer.

In most cases, pulmonary lymphoma is classified as a low-grade (indolent) B-cell non-Hodgkin's lymphoma that develops in mucosa-associated lymphoid tissue (MALT). However, as many as twenty percent of cases are high-grade pulmonary lymphoma and present as an extremely aggressive disease. This aggressive type is more commonly found in patients who are immunocompromised.

How common is pulmonary lymphoma?

Primary pulmonary lymphoma is a very, very rare disease. It accounts for about one half of one percent of all lung cancers, and about the same percentage of non-Hodgkin's lymphomas.

What are some symptoms of pulmonary lymphoma?

Similar to other lymphomas, the symptoms associated with pulmonary lymphomas are non-specific and can be interpreted to be many different things. They are:

  • Fevers
  • Unexplained weight loss
  • Respiratory problems

Treatment and prognosis of pulmonary lymphoma

Because this cancer is so rare, the optimal treatment for pulmonary lymphoma remains in dispute. However, it is most commonly treated with R-CHOP combination chemotherapy or CHOP-related chemotherapy. The efficacy of surgical resection of the tumor has not been confirmed as a reliable therapeutic response.

That said, the median survival for patients with high-grade primary pulmonary lymphoma is around 8-10 years, provided the patient isn't immunocompromised by, for example, HIV infection.

Sources

  • Cadranel J, Wislez M, Antoine M. "Primary pulmonary lymphoma." Eur Respir J 2002;20(3):750-762.
  • Brown, S et al. "High-grade primary pulmonary B cell lymphoma presenting as a necrotic mass.(Teaching Cases of the Month)(Case study)." Respiratory Care. Daedalus Enterprises, Inc. 2011.

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