Primary pulmonary lymphoma: a surgical series

Primary pulmonary lymphoma (PPL) is a rare entity often underdiagnosed due to its non-specific clinical presentation. Our aim is to share our experience in the management of these lesions, which should be considered in the differential diagnosis of nodules affecting the lung parenchyma. We retrospectively studied a total of 14 patients who had undergone surgery between 2013 and 2021. We recorded pre- and post-operative information and conducted survival analyses. Of the 14 patients, seven were males. The mean age was 61.5. Most patients were asymptomatic. PPL presented predominantly as nodules or solid masses (71.4%), followed by consolidations with a pneumonia pattern and ground-glass nodule, with a median uptake on peak standardised uptake value (SUV) positron emission computed tomography of 5.7 mg/m². There were nine cases (64.3%) of mucosa-associated lymphoid tissue lymphoma (MALT), four cases of diffuse large B cell lymphoma (28.6%) and one case of follicular B cell lymphoma. Fifty percent received adjuvant chemotherapy. Only one patient had disease progression. After a median follow-up of 38.6 months, 11 patients (78.6%) were still alive and disease-free. The overall 5-year survival was 92.9%. In conclusion, the most frequent PPL is the MALT type. Surgery seems to play a key role in diagnosis and treatment.