Chest

Chest

Volume 133, Issue 2, February 2008, Pages 433-440
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Original Research
Neoplastic Disease
Marginal Zone B-Cell Lymphoma of Bronchus-Associated Lymphoid Tissue: Imaging Findings in 21 Patients

https://doi.org/10.1378/chest.07-1956Get rights and content

Background

Few articles have been published on imaging findings of marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue (BALT) of the lung. We present CT scan and 18F-fluorodeoxyglucose (FDG) PET scan findings of the disease.

Methods

From March 1995 to February 2007, 21 pretreatment patients (male patients, 9; female patients, 12; age range, 35 to 76 years; mean [± SD] age, 54 ± 10.4 years) were seen who had pathologic diagnoses of marginal zone B-cell lymphoma of BALT. After CT scans were reviewed searching for specific patterns and distribution of parenchymal lung lesions, patients were classified as having the following four different patterns: (1) single nodular or consolidative; (2) multiple nodular or areas of consolidation; (3) bronchiectasis and bronchiolitis; and (4) diffuse interstitial lung disease (DILD) patterns. In six patients, in whom PET/CT scanning was performed, the pattern and the extent of maximum standardized uptake values (mSUVs) of FDG uptake were described.

Results

A single nodular or consolidative pattern was observed in 7 of 21 (33%) patients, multiple nodular or areas of consolidation were observed in 9 patients (43%), bronchiectasis and bronchiolitis were observed in 3 patients (14%), and DILD was observed in 2 patients (10%). On PET scans (n = 6), lesions showed heterogeneous FDG uptake in five patients and homogeneous uptake in one patient, with mSUVs ranging from 2.2 to 6.3 (mean mSUV, 4.2 ± 1.48).

Conclusions

Marginal zone B-cell lymphomas of BALT manifest diverse patterns of lung abnormality on CT scans, but single or multiple nodules or areas of consolidation are the main patterns that occur in a majority (76%) of patients. Most lesions show heterogeneous but identifiable FDG uptake on PET scans.

Section snippets

Materials and Methods

Our institutional review board approved our retrospective study with a waiver of informed consent.

Demographic Findings

Three patients had associated conditions, as follows: two patients, Sjögren syndrome; one patient, systemic lupus erythematosus. Four men were smokers (mean smoking history, 27 pack-years; range, 20 to 35 pack-years), and the remaining 17 men were nonsmokers. Nine patients had respiratory symptoms (cough, seven patients; dyspnea, four patients). In 12 asymptomatic patients, lung abnormalities were detected incidentally. For these patients, a chest CT scan was performed for the following other

Discussion

According to a study7 describing 10 cases of marginal zone B-cell lymphoma of BALT, the main patterns of lung lesions seen on CT scans were airspace consolidation or nodules containing air bronchograms within the lesions. In this study, the lesions were multiple in seven cases (70%) and bilateral in six cases (60%). In our study, a multiplicity of lesions was observed in 14 patients (70%), and bilateral disease was observed in 9 patients (43%). Moreover, in our study, CT scan findings were more

References (13)

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The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

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Copyright © 2008 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.