Background: Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a rare, indolent subtype of non-Hodgkin lymphoma with distinct radiological and pathological characteristics. Clinically, patients may present with nonspecific symptoms such as cough or dyspnea, and the disease can mimic other pulmonary conditions. High-resolution computed tomography (HRCT) imaging plays a critical role in identifying characteristic lung patterns, such as nodules, consolidation, or ground-glass opacities, which help in differentiating pulmonary MALT lymphoma from other pulmonary disorders. The study aimed to identify clinical characteristics based on the HRCT imaging features and pathological findings in patients with pulmonary MALT lymphoma.
Methods: The retrospective study involved 20 confirmed cases of pulmonary MALT lymphoma from a thoracic specialty hospital. Comprehensive data analysis included HRCT imaging characteristics such as tumor size, location, bronchial changes and peritumoral pulmonary interstitial infiltration, as well as pathological features, including cell type, morphology, and immunohistochemistry.
Results: HRCT imaging showed a high prevalence of air bronchogram (100%) and bronchiectasis (85%), with tumors predominantly located in the left upper lobe. Pathologically, tumors predominantly exhibited monocytoid and centrocyte-like cells, minimal atypia, and B-cell markers like CD20 and CD3 expression. Surgical resection was the primary treatment modality in 60% of cases, with the rest receiving chemical treatment.
Conclusions: Significant features evident in both HRCT imaging and pathological analysis were identified in pulmonary MALT lymphoma cases. These findings are anticipated to play a crucial role in facilitating early diagnosis and determining optimal treatment strategies.
Keywords: Pulmonary mucosa-associated lymphoid tissue lymphoma (pulmonary MALT lymphoma); high-resolution computed tomography imaging (HRCT imaging); pathology; immunohistochemistry; non-Hodgkin lymphoma
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Key findings
• High-resolution computed tomography (HRCT) imaging revealed common features such as air bronchogram (100%) and bronchiectasis (85%), predominantly in the left upper lobe.
• Pathological analysis identified tumors characterized by monocytoid and centrocyte-like cells, minimal atypia, and expression of B-cell markers CD20 and CD3.
What is known and what is new?
• Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is recognized as a rare and slow-growing type of non-Hodgkin lymphoma. It exhibits distinctive characteristics in both radiological (HRCT imaging) and pathological assessments.
• This study highlights specific clinical characteristics observed through HRCT imaging, such as a high prevalence of air bronchogram and bronchiectasis, particularly in the left upper lobe. Pathologically, the tumors predominantly feature monocytoid and centrocyte-like cells with minimal atypia and express B-cell markers CD20 and CD3.
What is the implication, and what should change now?
• The high prevalence of characteristic HRCT features such as air bronchogram and bronchiectasis in pulmonary MALT lymphoma suggests these can serve as diagnostic markers, aiding in early identification and differentiation from other pulmonary conditions. Further research is needed to validate these findings across larger patient cohorts and explore additional imaging modalities or biomarkers that could further enhance diagnostic accuracy and prognostic assessment.
