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Pulmonary lymphoid disorders

M N Koss1

  • 1Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.

Seminars in Diagnostic Pathology
|May 1, 1995
PubMed
Summary
This summary is machine-generated.

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Bronchus-associated lymphoid tissue (BALT) plays a key role in pulmonary lymphoid proliferations, including lymphomas and lymphomatoid granulomatosis. Understanding BALT

Area of Science:

  • Pulmonary Pathology
  • Immunopathology
  • Oncology

Background:

  • Bronchus-associated lymphoid tissue (BALT) is normally found in the airway walls and can undergo hyperplastic and neoplastic changes in disease.
  • Pulmonary lymphoid proliferations, including lymphomas and lymphomatoid granulomatosis, can be understood within the framework of BALT.
  • Conditions like acquired immune deficiency syndrome (AIDS) may involve viral causes such as human immunodeficiency virus (HIV) or Epstein-Barr virus (EBV) in diffuse lymphoid hyperplasia.

Purpose of the Study:

  • To elucidate the role of BALT in pulmonary lymphoid proliferations.
  • To differentiate between reactive lymphoid hyperplasia and neoplastic processes in the lung.
  • To explore the potential viral etiologies, including EBV, in lymphomatoid granulomatosis.

Main Methods:

Related Experiment Videos

  • Histopathological examination of pulmonary lymphoid lesions.
  • Immunohistochemical and in situ hybridization techniques to identify cellular origins and viral presence.
  • Clinical behavior analysis, including recurrence patterns.

Main Results:

  • Pulmonary lymphomas are typically low-grade B cell lymphomas originating from BALT, often showing "centrocytelike" cells and reactive germinal centers.
  • Lymphoid hyperplasia of BALT can manifest as follicular, nodular, or diffuse patterns.
  • Lymphomatoid granulomatosis is a polymorphous, angiocentric lesion predominantly T-cell, with EBV implicated in the atypical B cells.

Conclusions:

  • BALT serves as a crucial organizing principle for understanding pulmonary lymphoid proliferations.
  • Low-grade pulmonary lymphomas share histological and clinical features consistent with a BALT origin.
  • Lymphomatoid granulomatosis may represent a spectrum of T-cell lymphoproliferations driven by EBV infection.