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Silent imposter in pneumonic attire: primary pulmonary MALT lymphoma

Javeeria Shabbir1, Somesh Thakur2, Jisha G Panicker2

  • 1Department of Pulmonary Medicine, AIIMS, Patna, India javeeriashabbir@gmail.com.

BMJ Case Reports
|February 6, 2026
PubMed

Insights

Primary pulmonary lymphoma (PPL), a rare lung cancer, was diagnosed in a young man with persistent pneumonia symptoms. Effective treatment with chemoimmunotherapy led to clinical improvement, underscoring PPL

Area of Science:

  • Oncology
  • Pulmonology
  • Hematology

Background:

  • Primary pulmonary lymphoma (PPL) is a rare extranodal lymphoma, comprising less than 1% of non-Hodgkin lymphomas.
  • PPL is confined to the lungs and can present with symptoms mimicking pneumonia, leading to diagnostic challenges.

Purpose of the Study:

  • To report a case of primary pulmonary lymphoma (PPL) in a young adult.
  • To highlight the diagnostic difficulties and successful treatment of PPL.

Main Methods:

  • A case study of a man in his early 30s with progressive dyspnea, fever, and cough.
  • Diagnostic procedures included transbronchial lung biopsy for histopathology and immunohistochemistry, and PET-CT scan.
  • Treatment involved rituximab-bendamustine chemoimmunotherapy.

Main Results:

  • Histopathology confirmed extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue.
  • PET-CT indicated localized pulmonary involvement consistent with PPL.
  • The patient showed significant clinical improvement following chemoimmunotherapy.

Conclusions:

  • PPL should be considered in cases of non-resolving pulmonary consolidations, even in young patients.
  • Timely diagnosis through histopathology and advanced imaging is crucial.
  • Chemoimmunotherapy, such as rituximab-bendamustine, can be an effective treatment for PPL.
Keywords:
PathologyPneumonia (infectious disease)Respiratory cancerRespiratory medicine

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