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Summary

Marginal zone lymphoma (MZL), a rare non-Hodgkin lymphoma, can affect the lungs. This case highlights extranodal MZL presenting as a pulmonary consolidation, requiring biopsy for diagnosis.

Keywords:
extranodal mzlmaltomamarginal zone lymphomaproblem-solvingpulmonary maltoma

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Area of Science:

  • Hematology
  • Oncology
  • Pulmonology

Background:

  • Marginal zone lymphoma (MZL) is an uncommon non-Hodgkin lymphoma with nodal, splenic, and extranodal subtypes.
  • Extranodal MZL, particularly mucosa-associated lymphoid tissue (MALT) lymphoma, frequently involves extranodal sites such as the stomach, lung, and salivary glands.
  • Pulmonary MALT lymphoma can present with varied symptoms depending on the specific lung location.

Observation:

  • A patient presented with a right middle lobe lung consolidation initially treated empirically with antibiotics without improvement.
  • Bronchoscopy revealed extensive lymphoid infiltrates, and CT-guided biopsy confirmed extranodal marginal zone lymphoma.
  • Positron emission tomography (PET) CT showed mild uptake in the consolidation without distant metastases.

Findings:

  • Bronchoscopy is often nondiagnostic for pulmonary MALT lymphoma; lung biopsy is crucial for definitive diagnosis.
  • Extranodal marginal zone lymphoma was diagnosed in a patient presenting with a persistent lung consolidation.
  • Surgical resection (right middle lobectomy) was performed without complications.

Implications:

  • Accurate diagnosis of pulmonary MALT lymphoma requires tissue biopsy, often necessitating a lung biopsy.
  • Treatment strategies for MZL are tailored to tumor location and disease extent.
  • Extranodal marginal zone lymphoma, including pulmonary MALT lymphoma, generally has a favorable prognosis with high five-year survival rates (86-95%).