ObjectiveTo investigate the clinical, imaging features, diagnosis, treatment and prognosis of pulmonary lymphomatoid granulomatosis (PLG).MethodsA case of PLG confirmed by autopsy and pathology was reported, and the related literature was reviewed.ResultsA 44-year-old male patient presented with cough, expectoration and shortness of breath as the main symptoms. The imaging findings of lung CT were diffuse vascular nodular and patchy changes in the lungs, especially in the lower lung. Clinical symptoms were not relieved with anti-infection and symptomatic treatment. The patient's condition gradually exacerbated and finally died. The autopsy revealed PLG with pathological grade Ⅲ. The infiltration of lymphocytes centered with blood vessel and necrosis were observed under light microscope. EBER in situ hybridization was positive. Totally 28 Chinese articles and 34 foreign articles were screened out. Literature review suggested that PLG usually occurred in middle-aged men and was associated with EBV infection. It is frequent with immunodepression. Its clinical symptoms were atypical. The main imaging manifestations were multiple nodules and masses more frequent along the bronchovascular bundle. A diagnosis of PLG depended on pathological histology, immunohistochemistry and EBER in situ hybridization. Surgery was the main treatment for local lesions. The patients of grade I and Ⅱ with rapid progress and all grade Ⅲ were usually treated with RCHOP regimen combined with chemotherapy. The prognosis was correlated with grading. Grade Ⅲ was aggressive and the prognosis was poor.ConclusionsPLG is an atypical pulmonary lymphoproliferative disorder. It can be seen in many immunosuppressive diseases. The CT imaging features of PLG have certain characteristics, but the final diagnosis should be combined with pathological diagnosis. Some patients can be relieved by treatment, and patients with grade Ⅲ have poor prognosis.
ObjectiveTo study the clinical and pathological characteristics and imaging manifestations of pulmonary mucosa associated lymphoid tissue (MALT) lymphoma.MethodsThe clinical and multidetector computed tomography (MDCT) imaging data of 17 patients with pathological proven pulmonary MALT lymphoma were reviewed retrospectively.ResultsThe MDCT manifestations were divided into 4 types: ① pneumonia/consolidation, ② mass/nodule type, ③ bronchovascular lymphatic type, ④ mixed type. The imaging features included air bronchiectasis in 13 cases and bronchiectasis in 9 cases. Multiple small pulmonary nodules were found in 11 cases, ground glass opacity in 9 cases, 4 cases of pleural effusion, pulmonary hilar and mediastinal lymph node enlargement in 3 cases. Among these 17 cases, 4 had extra-pulmonary involvement and 2 without obvious symptoms. The main clinical symptoms including cough, expectoration, dyspnea, fever, chest pain, hemoptysis, night sweats. The pathological manifestation is the infiltration of a large number of B lymphocytes and nuclear heterocells.ConclusionsThe clinical manifestations of pulmonary MALT lymphoma are not specific, but the progress is slow, and may be associated with autoimmune diseases. The main MDCT findings of pulmonary MALT lymphoma include consolidation, nodules or masses with air bronchogram. Lymph node enlargement is rare. Clinical diagnosis should also be based on pathological results.