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Giant lamellar bodies in pulmonary MALT lymphoma. A case report
M Hirokawa1, T Kanahara, S Ariyasu
1Department of Pathology, Kawasaki Medical School, Kurashiki, Japan. hirokawa@basic.med.tokushima-u.ac.jp
Insights
Giant lamellar bodies, large structures found in the lungs, were identified using cytology in a patient with pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. This finding offers new insights into diagnosing lung lymphomas.
Area of Science:
- Pulmonology
- Cytopathology
- Oncology
Background:
- Giant lamellar bodies are rare, laminated structures observed in lung alveolar spaces.
- Cytologic findings of giant lamellar bodies have not been previously reported.
- This study describes giant lamellar bodies in association with pulmonary MALT lymphoma.
Observation:
- Cytologic smears revealed numerous giant lamellar bodies (15-40 microns) with central necrotic debris.
- The background showed small to medium lymphoid and plasmacytoid cells.
- Histology confirmed IgG, kappa type, MALT lymphoma.
Findings:
- Giant lamellar bodies were found within dilated alveolar spaces lined by hypertrophied type II pneumocytes.
- Immunohistochemistry showed giant lamellar bodies were positive for KL-6.
- These structures may originate from surfactant and necrotic type II pneumocytes.
Implications:
- Cytologic identification of giant lamellar bodies can aid in diagnosing pulmonary MALT lymphoma.
- This finding expands the understanding of cytomorphology in lung lymphomas.
- KL-6 positivity suggests a relationship with type II pneumocyte origin.
Background:
Giant lamellar bodies are laminated, scroll-like whorls seen within alveolar spaces and have been occasionally observed in sclerosing hemangioma of the lung. However, to the best of our knowledge, the cytologic findings of giant lamellar bodies have not been reported. We describe cytologic findings of giant lamellar bodies associated with pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.
Case:
A 72-year-old male had a pulmonary mass measuring 2.0 x 1.4 x 1.5 cm. Cytologic smears imprinted from a cut surface of the resected mass revealed a large number of concentrically laminated structures, giant lamellar bodies, measuring 15-40 microns in diameter. Necrotic cellular remnants were occasionally observed in the center of the structures. In the background, small to medium-sized lymphoid cells and plasmacytoid cells were observed. Histologic diagnosis of the tumor was IgG, kappa type, MALT lymphoma. An aggregate of giant lamellar bodies was observed within entrapped, dilated alveolar spaces lined with hypertrophied, type II pneumocytes. Immunohistochemically, the giant lamellar bodies were positive for KL-6.
Conclusion:
Giant lamellar bodies may be derived from surfactant and necrotic type II pneumocytes and may be observed cytologically in cases of pulmonary MALT lymphoma.