Diagnostic and prognostic factors for patients with primary pulmonary non‑Hodgkin's lymphoma: A 16‑year single‑center retrospective study

Qian,Jiang; Luo,Dong‑Lan; Zhang,Jin‑E; Li,Wen‑Yu; Gao,Xing‑Lin; Fang,Xiang‑Feng; An,Hong; Deng,Jun‑Liang; Li,Qiong; Wu,Jian

doi:10.3892/ol.2019.10469

Diagnostic and prognostic factors for patients with primary pulmonary non‑Hodgkin's lymphoma: A 16‑year single‑center retrospective study

Authors:
- Jiang Qian
- Dong‑Lan Luo
- Jin‑E Zhang
- Wen‑Yu Li
- Xing‑Lin Gao
- Xiang‑Feng Fang
- Hong An
- Jun‑Liang Deng
- Qiong Li
- Jian Wu
View Affiliations

Affiliations: Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China, Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China, Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China, Department of Lymphoma, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, Guangdong 510080, P.R. China
Published online on: June 12, 2019 https://doi.org/10.3892/ol.2019.10469
Pages: 2082-2090

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Primary pulmonary non‑Hodgkin's lymphoma (PP‑NHL) is a rare entity with non‑specific symptoms and radiographic findings, as well as a difficult preoperative diagnosis. A limited number of studies have described PP‑NHL in Chinese patients. The goal of the present study was to improve early diagnosis by examining prognostic factors in patients with PP‑NHL. Therefore, a total of 29 patients with PP‑NHL were included in the study between January 2001 and June 2017, including 14 with aggressive‑type and 15 with indolent‑type lymphomas (10 male, 19 female; median age, 50.3 years; range, 19‑87 years). Pulmonary nodules and masses (55.2%) were the most common radiographic features. The diagnostic yield was 80% (12/15) by endobronchial biopsy or transbronchial lung biopsy and 100% by computed tomography (CT)‑guided percutaneous needle lung biopsy (11/11) or surgery (8/8). Elevated lactate dehydrogenase levels and systemic symptoms were observed considerably more often in patients with aggressive disease than in those with indolent disease. The 1‑, 3‑ and 5‑year overall survival (OS) rates were 42, 32, and 21%, respectively, for all patients, 72, 57 and 43%, respectively, for patients with indolent lymphomas, and 13, 6 and 0%, respectively, for patients with aggressive lymphomas. The median OS rate for all patients was 12.0 months; however, the OS rate for patients with aggressive lymphomas was significantly shorter compared with those with indolent lymphomas (7.1 months vs. 16.6 months; P=0.002). Aggressive vs. indolent lymphoma status was indicated to be an independent prognostic factor for poor 5‑year OS rate (hazard ratio, 5.98; P=0.014). In conclusion, bronchoscopic and CT‑guided percutaneous needle lung biopsies were the most useful and least invasive procedures for diagnosing PP‑NHL. Furthermore, aggressive PP‑NHL was highly associated with poor 5‑year OS rate and a poor prognosis.

View Figures

View References

1	Cadranel J, Wislez M and Antoine M: Primary pulmonary lymphoma. Eur Respir J. 20:750–762. 2002. View Article : Google Scholar : PubMed/NCBI
2	Parissis H: Forty years literature review of primary lung lymphoma. J Cardiothorac Surg. 6:232011. View Article : Google Scholar : PubMed/NCBI
3	Delgado Torralbo JA, García Gómez LC and Sánchez Varilla JM: Unilateral lung infiltrate: A rare form of presentation of primary pulmonary lymphoma. Arch Bronconeumol. 54:103–104. 2018.(In English, Spanish). View Article : Google Scholar : PubMed/NCBI
4	Dong Y, Zeng M, Zhang B, Han L, Liu E, Lian Z, Liu J, Liang C and Zhang S: Significance of imaging and clinical features in the differentiation between primary and secondary pulmonary lymphoma. Oncol Lett. 14:6224–6230. 2017.PubMed/NCBI
5	Nicholson AG and Harris NL: Marginal zone diffuse B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type. World Health Organization Classification of Tumoours. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. Travis WB, Brambilla A, Muller-Hermelinck HK and Harris CC: Lyon, France: IARC Press; pp. 88–90. 2004
6	Graham BB, Mathisen DJ, Mark EJ and Takvorian RW: Primary pulmonary lymphoma. Ann Thorac Surg. 80:1248–1253. 2005. View Article : Google Scholar : PubMed/NCBI
7	Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, Advani R, Ghielmini M, Salles GA, Zelenetz AD and Jaffe ES: The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 127:2375–2390. 2016. View Article : Google Scholar : PubMed/NCBI
8	Cordier JF, Chailleux E, Lauque D, Reynaud-Gaubert M, Dietemann-Molard A, Dalphin JC, Blanc-Jouvan F and Loire R: Primary pulmonary lymphomas. A clinical study of 70 cases in nonimmunocompromised patients. Chest. 103:201–208. 1993. View Article : Google Scholar : PubMed/NCBI
9	Vanden Eynden F, Fadel E, de Perrot M, de Montpreville V, Mussot S and Dartevelle P: Role of surgery in the treatment of primary pulmonary B-cell lymphoma. Ann Thorac Surg. 83:236–240. 2007. View Article : Google Scholar : PubMed/NCBI
10	Kim JH, Lee SH, Park J, Kim HY, Lee SI, Park JO, Kim K, Kim WS, Jung CW, Park YS, et al: Primary pulmonary non-Hodgkin's lymphoma. Jpn J Clin Oncol. 34:510–514. 2004. View Article : Google Scholar : PubMed/NCBI
11	Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, Rosenberg SA, Coltman CA and Tubiana M: Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol. 7:1630–1636. 1989. View Article : Google Scholar : PubMed/NCBI
12	Zelenetz AD, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Bellam N, Byrd JC, Czuczman MS, Fayad LE, et al: Non-Hodgkin's lymphomas, version 1.2013. J Natl Compr Canc Netw. 11:257–272; quiz 273. 2013. View Article : Google Scholar : PubMed/NCBI
13	Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, et al: Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI sponsored international working group. J Clin Oncol. 17:12441999. View Article : Google Scholar : PubMed/NCBI
14	Borie R, Wislez M, Thabut G, Antoine M, Rabbat A, Couderc LJ, Monnet I, Nunes H, Blanc FX, Mal H, et al: Clinical characteristics and prognostic factors of pulmonary MALT lymphoma. Eur Respir J. 34:1408–1416. 2009. View Article : Google Scholar : PubMed/NCBI
15	Ogusa E, Tomita N, Ishii Y, Takasaki H, Hattori Y, Matsumoto C and Ishigatsubo Y: Clinical manifestations of primary pulmonary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in Japanese population. Hematol Oncol. 31:18–21. 2013. View Article : Google Scholar : PubMed/NCBI
16	Huang J, Lin T, Li ZM, Xu R, Huang H and Jiang W: Primary pulmonary non-Hodgkin's lymphoma: A retrospective analysis of 29 cases in a Chinese population. Am J Hematol. 85:523–525. 2010. View Article : Google Scholar : PubMed/NCBI
17	Neri N, Jesus Nambo M and Aviles A: Diffuse large B-cell lymphoma primary of lung. Hematology. 16:110–112. 2011. View Article : Google Scholar : PubMed/NCBI
18	Hu YH, Hsiao LT, Yang CF, Chiou TJ, Liu JH, Gau JP, Yen CC, Chou TY, Hsu WH, Chen PM and Tzeng CH: Prognostic factors of Chinese patients with primary pulmonary non-Hodgkin's lymphoma: The single-institute experience in Taiwan. Ann Hematol. 88:839–846. 2009. View Article : Google Scholar : PubMed/NCBI
19	Sirajuddin A, Raparia K, Lewis VA, Franks TJ, Dhand S, Galvin JR and White CS: Primary pulmonary lymphoid lesions: Radiologic and pathologic findings. Radiographics. 36:53–70. 2016. View Article : Google Scholar : PubMed/NCBI
20	Yao D, Zhang L, Wu PL, Gu XL, Chen YF, Wang LX and Huang XY: Clinical and misdiagnosed analysis of primary pulmonary lymphoma: A retrospective study. BMC Cancer. 18:2812018. View Article : Google Scholar : PubMed/NCBI
21	Borie R, Wislez M, Antoine M, Fleury-Feith J, Thabut G, Crestani B, Monnet I, Nunes H, Delfau-Larue MH and Cadranel J: Clonality and phenotyping analysis of alveolar lymphocytes is suggestive of pulmonary MALT lymphoma. Respir Med. 105:1231–1237. 2011. View Article : Google Scholar : PubMed/NCBI
22	Cardenas-Garcia J, Talwar A, Shah R and Fein A: Update in primary pulmonary lymphomas. Curr Opin Pulm Med. 21:333–337. 2015. View Article : Google Scholar : PubMed/NCBI
23	Matsumoto T, Otsuka K, Funayama Y, Imai Y and Tomii K: Primary pulmonary lymphoma mimicking a refractory lung abscess: A case report. Oncol Lett. 9:1575–1578. 2015. View Article : Google Scholar : PubMed/NCBI
24	Agarwal KK, Dhanapathi H, Nazar AH and Kumar R: Primary pulmonary lymphoma-role of fluoro-deoxy-glucose positron emission tomography-computed tomography in the initial staging and evaluating response to treatment-case reports and review of literature. Indian J Nucl Med. 31:194–197. 2016. View Article : Google Scholar : PubMed/NCBI
25	Wang L, Xia ZJ, Zhang YJ, Huang HQ, Lin TY and Lu Y: Radical surgery may be not an optimal treatment approach for pulmonary MALT lymphoma. Tumour Biol. 36:6409–6416. 2015. View Article : Google Scholar : PubMed/NCBI
26	Sammassimo S, Pruneri G, Andreola G, Montoro J, Steffanoni S, Nowakowski GS, Gandini S, Negri M, Habermann TM, Raderer M, et al: A retrospective international study on primary extranodal marginal zone lymphoma of the lung (BALT lymphoma) on behalf of International Extranodal Lymphoma Study Group (IELSG). Hematol Oncol. 34:177–183. 2016. View Article : Google Scholar : PubMed/NCBI
27	Ferraro P, Trastek VF, Adlakha H, Deschamps C, Allen MS and Pairolero PC: Primary non-Hodgkin's lymphoma of the lung. Ann Thorac Surg. 69:993–997. 2000. View Article : Google Scholar : PubMed/NCBI
28	Jiang AG, Gao XY and Lu HY: Diagnosis and management of a patient with primary pulmonary diffuse large B-cell lymphoma: A case report and review of the literature. Exp Ther Med. 8:797–800. 2014. View Article : Google Scholar : PubMed/NCBI
29	Medeiros LJ and Elenitoba-Johnson KS: Anaplastic large cell lymphoma. Am J Clin Pathol. 127:702–722. 2007. View Article : Google Scholar
30	Kocaturk CI, Seyhan EC, Gunluoglu MZ, Urer N, Kaynak K, Dincer SI and Bedirhan MA: Primary pulmonary non-Hodgkin's lymphoma: Ten cases with a review of the literature. Tuberk Toraks. 60:246–253. 2012. View Article : Google Scholar : PubMed/NCBI
31	Hare SS, Souza CA, Bain G, Seely JM, Frcp c, Gomes MM and Quigley M: The radiological spectrum of pulmonary lymphoproliferative disease. Br J Radiol. 85:848–864. 2012. View Article : Google Scholar : PubMed/NCBI