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Pulmonary lymphomas simulating lymphomatoid granulomatosis
The American Journal of Surgical Pathology
|January 1, 1982
Summary
Malignant lymphomas in the lung, both primary and secondary, often show vascular infiltration, mimicking other conditions. Accurate diagnosis requires careful examination for atypical lymphoid cells, as prognosis is poor.
Area of Science:
- Pulmonary Medicine
- Oncology
- Pathology
Background:
- Malignant lymphomas can present in the lung, either primarily or secondarily.
- Vascular infiltration by lymphoid cells is a common feature in pulmonary lymphomas.
- This vascular infiltration can lead to diagnostic confusion with conditions like lymphomatoid granulomatosis.
Purpose of the Study:
- To investigate the clinicopathologic features of malignant lymphomas involving the lung.
- To highlight the diagnostic challenges posed by vascular infiltration in pulmonary lymphomas.
- To assess the prognosis of patients with primary pulmonary lymphoma.
Main Methods:
- Histologic examination of 30 cases of pulmonary lymphoma (20 primary, 10 secondary).
- Analysis of clinical and radiologic findings at presentation.
- Correlation of histologic features with diagnosis and patient outcomes.
Main Results:
- Prominent vascular infiltration was observed in all studied cases.
- Histologic features included extensive necrosis and a polymorphous benign infiltrate.
- Diagnosis of lymphoma required identification of monomorphous atypical lymphoid cells, sometimes necessitating extensive tissue sampling.
- Clinical and radiologic findings were nonspecific, including nodules and infiltrates.
- The prognosis for primary pulmonary lymphoma was poor, with a 2-year mortality of 50%.
Conclusions:
- Pulmonary lymphomas, especially those with vascular infiltration, present diagnostic challenges.
- Careful histologic evaluation is crucial for accurate lymphoma diagnosis in the lung.
- Primary pulmonary lymphoma carries a poor prognosis.