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Vol. 40. Issue 2.
Pages 94-96 (February 2004)
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Vol. 40. Issue 2.
Pages 94-96 (February 2004)
Case Reports
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Primary Pulmonary Lymphoma Presenting as a Pulmonary Mass With Cavitation
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C. Martínez Rivera
Corresponding author
med003790@saludalia.com

Correspondence: C. Martinez Rivera. Hospital Sagrat Cor. Viladomat, 288. 08029 Barcelona. España
, M. Bonnin Vilaplana, C. Simón Adiego, A. Palacín Forgué, J. Puig Zuza, I. Sampablo Lauro
Hospital Sagrat Cor, Barcelona, Spain
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Primary pulmonary lymphoma is a rare entity usually formed of B-type cells, usually low-grade and composed of mucosal- or bronchial-associated lymphoid tissue. High-grade primary pulmonary lymphomas usually occur in immunodeficient patients who mostly present with respiratory and nonspecific symptoms. A chest x-ray may show a pulmonary mass or atelectasis and pleural effusion. In such cases, the prognosis is worse than for low-grade pulmonary lymphomas; survival is 8 to 10 years and there is a higher probability of local progression or metastasis. We report the case of an immunocompetent 76-year-old patient who had a pulmonary mass with cavitation secondary to a large B-cell primary pulmonary lymphoma. After the fourth session of chemotherapy the pulmonary mass was reduced in size and an aspergilloma was seen to have developed in the residual cavity. A review of the literature revealed this case to be anecdotal as it is extremely infrequent for a primary pulmonary lymphoma to present in the form of a single mass with cavitation and with few symptoms.

Key words:
Cavitated mass
Primary pulmonary lymphoma
High-grade
B-cells

El linfoma pulmonar primario es una entidad poco frecuente, que en la mayoría de las ocasiones es de estirpe celular tipo B, predominantemente de bajo grado y de tejido linfoide asociado a la mucosa (MALT/BALT). Los linfomas pulmonares primarios de alto grado suelen presentarse en pacientes inmunodeprimidos. Habitualmente se presentan con síntomas respiratorios y generales. La radiografía de tórax puede mostrar una masa pulmonar o atelectasia y derra-me pleural. El pronóstico es peor que en los linfomas pulmonares de bajo grado, con un tiempo de supervivencia de 8-10 años y una mayor probabilidad de progresión local o recidiva a distancia. Presentamos el caso de un paciente de 76 años no inmunodeprimido con una masa pulmonar cavitada secundaria a un linfoma pulmonar primario tipo B de células grandes. Después de la cuarta sesión de quimioterapia se objetivó una reducción de la masa pulmonar y en la cavidad residual se desarrolló un aspergiloma. Revisando la bibliografía se ha comprobado lo anecdótico del caso presentado, pues es extremadamente poco frecuente que un linfoma pulmonar primario se presente en forma de masa cavitada única y con poca repercusión clínica en cuanto a sintomatología general.

Palabras clave:
Masa cavitada
Linfoma pulmonar primario
Alto grado
Células B
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REFERENCES
[1]
PG Isaacson, AJ Norton.
Extranodal lymphomas, Churchill-Livingstone, (1994),
[2]
J Cadranel, M Wislez, M Antoine.
Primary pulmonary lymphoma.
Eur Respir J, 20 (2002), pp. 750-762
[3]
NL Harris, ES Jaffe, J Diebold, G Flandrin, HK Muller-Hermelink, J Vardiman.
Lymphoma classification–From controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms.
Am Oncol, 11 (2000), pp. 3-10
[4]
JJ Reina, M Ruiz, JC Valenzuela, MJ Valladares, P Borrega, A Viana, et al.
Linfoma no Hodgkin endobronquial primario: a propósito de un caso y revisión de la literatura.
An Med Interna (Madrid), 15 (1998), pp. 97-99
[5]
A Morgner, S Miehlke, W Fischbach, W Schmitt, H Muller-Hermelink, A Greiner, et al.
Complete remission of primary high-grade B-cell gastric lymphoma after cure of Helicobacter pylori infection.
J Clin Oncol, 19 (2001), pp. 2041-2048
[6]
JF Cordier, E Chailleux, D Lauque, M Reynaud-Gaubert, A Dietemann-Molard, JC Dalphin, et al.
Primary pulmonary lymphomas. A clinical study of 70 cases in nonimmunocompromised patients.
Chest, 103 (1993), pp. 201-208
[7]
P Ray, M Antoine, M Mary-Krause, MG Lebrette, M Wislez, C Duvivier, et al.
AIDS-related primary pulmonary lymphoma.
Am J Respir Crit Care Med, 158 (1998), pp. 1221-1229
[8]
AG Nicholson, AC Wotherspoon, TC Diss, DN Buther, MN Sheppard, PG Isaacson, et al.
Pulmonary B-cell non-Hodgkin's lymphomas. The value of immunohistochemistry and gene analysis in diagnosis.
Histopathology, 26 (1995), pp. 395-403
[9]
RJ L'Hoste Jr, DA Filippa, PH Lieberman, S Bretsky.
Primary pulmonary lymphomas. A clinicopathologic analysis of 36 cases.
Cancer, 54 (1984), pp. 1397-1406
[10]
N Miyahara, R Eda, Y Umemori, T Murakami, N Kunichika, K Makihata, et al.
Pulmonary lymphoma of large B-cell type mimicking Wegener's granulomatosis.
Intern Med, 40 (2001), pp. 786-790
[11]
BT Collins.
Cavitary lung mass representing primary pulmonary malignant lymphoma with initial diagnosis by fine needle aspiration biopsy.
Acta Cytol, 45 (2001), pp. 901-903
Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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