T-cell and NK-cell lymphomas in the lung

Area of Science:

• Pulmonology
• Oncology
• Pathology

Background:

• Primary pulmonary lymphoma is rare, comprising <1% of extranodal lymphomas.
• T-cell lymphoma in the lung, as primary or secondary disease, is exceptionally uncommon.
• Pulmonary T-cell lymphoma often presents with symptoms mimicking pneumonia, leading to delayed diagnosis.

Purpose of the Study:

• To highlight the rarity and diagnostic challenges of primary pulmonary T-cell lymphoma.
• To outline typical clinical and radiologic features.
• To emphasize the importance of accurate diagnosis and WHO classification.

Main Methods:

• Review of clinical presentations and radiologic findings in pulmonary T-cell lymphoma.
• Discussion of diagnostic modalities including CT-guided needle biopsy and bronchoscopic examination.
• Emphasis on precise pathologic diagnosis and molecular characterization per WHO classification.

Main Results:

• Common symptoms include cough, dyspnea, fever, and hemoptysis.
• Radiologic findings may include nodules, consolidation, opacities, cystic changes, adenopathy, and effusions.
• Initial misdiagnosis as pneumonia is frequent, necessitating consideration of biopsy.

Conclusions:

• Pulmonary T-cell lymphoma requires a high index of suspicion, especially when symptoms persist despite antibiotic treatment.
• Accurate diagnosis through biopsy and molecular characterization is essential.
• Treatment principles are guided by specific histologic subtypes of T-cell lymphoma.