Case Report
Pulmonary Malt Lymphoma With Amyloidosis: An Uncommon Pulmonary Entity
Beatriz García Pulido
, Alejandro Fernández Fernández
Corresponding author
Facultativo Especialista de Neumología, Hospital Grande Covián, Oriente de Asturias, Asturias, Spain
Read
275
Timeswas read the article
86
Total PDF
189
Total HTML
Share statistics
array:22 [ "pii" => "S030028962300371X" "issn" => "03002896" "doi" => "10.1016/j.arbres.2023.10.013" "estado" => "S300" "fechaPublicacion" => "2024-02-01" "aid" => "3434" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:107-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:17 [ "pii" => "S0300289623004015" "issn" => "03002896" "doi" => "10.1016/j.arbres.2023.11.016" "estado" => "S300" "fechaPublicacion" => "2024-02-01" "aid" => "3445" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:109" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Carcinosarcoma: A Rare Lung Tumor" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "109" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 903 "Ancho" => 900 "Tamanyo" => 142382 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT, endobronquial tumor, TBNA performed with endobronchial ultrasound (EBUS) and histological image.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana María Andrés Blanco, Milko Terranova Ríos, Alvaro Pérez Rodríguez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ana María" "apellidos" => "Andrés Blanco" ] 1 => array:2 [ "nombre" => "Milko" "apellidos" => "Terranova Ríos" ] 2 => array:2 [ "nombre" => "Alvaro" "apellidos" => "Pérez Rodríguez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289623004015?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000002/v3_202406051408/S0300289623004015/v3_202406051408/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S030028962300368X" "issn" => "03002896" "doi" => "10.1016/j.arbres.2023.11.004" "estado" => "S300" "fechaPublicacion" => "2024-02-01" "aid" => "3431" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:105-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "A Unique Side Effect Associated With Continuous Positive Airway Pressure Therapy: Right-Sided Edematous Change and Pleural Effusion" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "105" "paginaFinal" => "106" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1654 "Ancho" => 2340 "Tamanyo" => 273173 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CXR images (A, B, E, and F), contrast-enhanced chest computed tomography images (C and D). (A) Before the initiation of CPAP therapy. (B–D) Two days after the initiation of CPAP therapy. (E) The day after the discontinuation of CPAP therapy. (F) One week after the discontinuation of CPAP therapy. CPAP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>continuous positive airway pressure; CXR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>chest X-ray.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Satoshi Hamada, Toyohiro Hirai, Susumu Sato" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Satoshi" "apellidos" => "Hamada" ] 1 => array:2 [ "nombre" => "Toyohiro" "apellidos" => "Hirai" ] 2 => array:2 [ "nombre" => "Susumu" "apellidos" => "Sato" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962300368X?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000002/v3_202406051408/S030028962300368X/v3_202406051408/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Pulmonary Malt Lymphoma With Amyloidosis: An Uncommon Pulmonary Entity" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "107" "paginaFinal" => "108" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Beatriz García Pulido, Alejandro Fernández Fernández" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Beatriz" "apellidos" => "García Pulido" "email" => array:1 [ 0 => "beatrizgarciapulido@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Fernández Fernández" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Facultativo Especialista de Neumología, Hospital Grande Covián, Oriente de Asturias, Asturias, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 756 "Ancho" => 755 "Tamanyo" => 81531 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest scan.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Primary pulmonary lymphomas are uncommon entities in respiratory medicine<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>. They present most often as mucosa-associated lymphoid tissue (MALT) lymphomas (80%) in asymptomatic middle-aged adults in the form of pulmonary nodules that in some cases may be associated with amyloidosis<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3,4</span></a>. Diagnosis is not easy, and they may appear on a chest tomography (CT) as a pulmonary lesion with low attenuation in the interior. Lymphoid infiltration of the lung mucosa or a monoclonal tissue-level peak may be detected on bronchoscopy, but in the vast proportion of cases, surgical biopsy is required for confirmation. Located lesions can be treated with surgery or radiotherapy, and the rest can be treated with chemotherapy<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 62-year-old man with history of tuberculosis correctly treated at a younger age, with an active intake of 2–3 beers a day, was admitted to the hospital with a 1-week history of unproductive cough, asthenia and anorexia. No fever was reported at any time.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the medical examination, the patient showed good general condition, and no adenopathy was reported. In pulmonary auscultation, crackles in the left lower lobe (LLL) were present, without any other pathological signs in the rest of the examination.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In the blood tests, the findings were as follows: leukocytosis with neutrophilia, raised C-reactive protein and procalcitonin, slight alteration of liver function tests, and B12 vitamin 991.70<span class="elsevierStyleHsp" style=""></span>pg/mL. Chest radiography showed LLL opacity and urine antigens were negative for pneumococcus and legionella. All these findings were interpreted as LLL community-acquired pneumonia, and the patient received a 1-week course of levofloxacin 500<span class="elsevierStyleHsp" style=""></span>mg. There was no clinical or radiological improvement, so the drug therapy was adjusted to moxifloxacin 400<span class="elsevierStyleHsp" style=""></span>mg for 21 days. One month later, the patient attended our clinic. No changes were detected in the radiological image, so additional studies were implemented. A chest CT was performed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), showing a LLL opacity with air bronchogram, and multiple images of cavities with necrosis and bronchiectasis. The flexible bronchoscopy showed no endobronchial, bacterial or anatomopathological findings. Finally, we performed a CT-guided biopsy on the LLL lesion. Pathology results reported a low-grade B-small cell non-Hodgkin lymphoma, compatible with marginal MALT-type lymphoma associated with vascular and stromal lambda amyloidosis type A. This case was reviewed by the haematology department, who requested an abdominal scan, a positron emission tomography (PET) and an echocardiogram. Finally, the patient received radiotherapy to the lesion.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have not received any type of funding.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 756 "Ancho" => 755 "Tamanyo" => 81531 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest scan.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linfomas primarios de pulmón" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Martínez Baños" 1 => "J.M. Galbis Caravajal" 2 => "C. Ortiz Villalón" 3 => "A. Arnau Obrer" 4 => "S. Figueroa Almánzar" 5 => "N. Martínez Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s1576-9895(10)70006-0" "Revista" => array:5 [ "tituloSerie" => "Rev Patol Respir" "fecha" => "2010" "volumen" => "13" "paginaInicial" => "130" "paginaFinal" => "133" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amiloidosis pulmonar: un desafío diagnóstico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Guasch" 1 => "A. Ojanguren" 2 => "J.R. Gómez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ciresp.2019.03.008" "Revista" => array:6 [ "tituloSerie" => "Cirugía Española" "fecha" => "2020" "volumen" => "98" "paginaInicial" => "50" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31204007" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amiloidosis nodular pulmonar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Bruna Esteban" 1 => "A. Arnau Obrer" 2 => "A. Honguero Martínez" 3 => "M. Estors Guerrero" 4 => "A. Cantó Armengod" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0009-739x(07)71256-3" "Revista" => array:6 [ "tituloSerie" => "Cirugía Española" "fecha" => "2007" "volumen" => "81" "paginaInicial" => "43" "paginaFinal" => "45" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17263958" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Amiloidosis nodular pulmonar, una causa infrecuente de nódulos pulmonares múltiples" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Ruiz-Álvarez" 1 => "A.M. Gutiérrez Palacios" 2 => "B. Rodríguez Díaz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2019.11.024" "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2021" "volumen" => "57" "paginaInicial" => "227" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31902634" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000002/v3_202406051408/S030028962300371X/v3_202406051408/en/main.assets" "Apartado" => array:4 [ "identificador" => "93562" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000002/v3_202406051408/S030028962300371X/v3_202406051408/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962300371X?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 8 | 0 | 8 |
| 2024 August | 2 | 0 | 2 |
| 2024 May | 3 | 2 | 5 |
| 2024 March | 10 | 0 | 10 |
| 2024 February | 22 | 14 | 36 |
| 2024 January | 49 | 26 | 75 |
| 2023 December | 90 | 39 | 129 |
| 2023 November | 5 | 5 | 10 |
